case_images: PMC5769776_01
case_images: A perforation of the ulcer was observed in the gum on the bottom right jaw.
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case_images: Gross examination revealed perforation of an ulcer in the gum on the bottom right of the jaw (Figure 1).
case_images: Radiograph showing the bone transmission of the lower right jaw, floating teeth, and a pathological fracture of the mandible body. CT scan shows a cystic lesion on the same site as the pathological fracture.
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case_images: An X-ray showed a bone transmission image in the lower right jaw, floating teeth and a severe pathological fracture of the mandibular body (Figure 2). A computed tomography scan showed a cystic lesion on the same site as the pathological fracture (Figure 2).
case_images: MRI scan shows low signal on T1-weighted images and high signal on T2-weighted images.
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case_images: A magnetic resonance imaging (MRI) scan showed a low signal on T1-weighted images, and a high signal on T2-weighted images (Figure 3).
case_images: Haematoxylin-eosin staining indicating infiltration of eosinophils. The Langerhans cell-like cells in the periphery were S100 protein positive. The Langerhans cell-like cells in the periphery were CD1a positive.
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case_images: Immunohistochemical staining was S100 protein positive and CD1a positive (Figure 4); therefore, the diagnosis was LCH.
case_images: Mandible segmental resection and reconstruction by a free fibula flap were performed.
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case_images: Therefore, the diagnosis was LCH confined to the mandible, and a mandibular segmental resection and reconstruction using a free fibula flap was performed (Figure 5).
case_images: One month after the operation, intermaxillary fixation was performed to obtain a normal occlusion. No recurrence was observed more than two years after surgery.
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case_images: Normal occlusion was acquired, and no recurrence was observed more than two years after surgery (Figure 6).