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Eosinophilic granuloma is the localized and most benign form of Langerhans' cell histiocytosis. The disease shows a particular predilection for the head and neck region and usually involves the skull bones, where it manifests as well-defined lytic lesions on standard radiographs. The case of an extensive lesion involving the body of the mandible in a 52-year-old man is reported. Operative procedures consisted of enucleation of the lytic lesion and follow-up with clinical examinations and computerized tomographic studies of the mandible at 2, 12, and 18 months postoperatively. Reconstructive surgery without radiotherapy was performed with an autologous bone graft from the iliac crest and implant placement to provide support for a dental restoration.

Eosinophilic granuloma in children occurs in descending frequency in the skull, femur, ribs, pelvis, and spine. The varying degrees of radiographic diagnostic certainty indicate that biopsy is frequently required for diagnosis. The orthopedist should extend his involvement in such patients from the biopsy to prevention of deformity during the subsequent treatment and healing of the lesion.