Resorbable plating systems have been adapted into routine use for craniofacial reconstruction in children. After implantation in some patients, the area around the plates can develop palpable and visible fibrous capsules, with underlying bone resorption and a significant foreign-body giant cell reaction. The reaction is usually self-limited. We report a case in which Langerhans cell histiocytosis was resected, and then recurred at the sites of resorbing plate and screw placement in association with a foreign-body giant cell reaction.

Bas B, et al: Eosinophilic granuloma: resolution of lesion after biopsy. J Craniofac Surg 2011;22:2409-2412.
Angeli SI, et al: Langerhans' cell histiocytosis of the head and neck in children. Ann Otol Rhinol Laryngol 1995;104:173-180.
Broadbent V, Egeler RM, Nesbit ME Jr: Langerhans cell histiocytosis - clinical and epidemiological aspects. Br J Cancer Suppl 1994;23:S11-S16.
DiNardo LJ, Wetmore RF: Head and neck manifestations of histiocytosis-X in children. Laryngoscope 1989;99:721-724.
Martinez-Perez D, Mulliken JB, Arceci RC: Langerhans cell histiocytosis: an uncommon disease commonly manifesting in the craniofacial skeleton. Plast Reconstr Surg 1996;98:211-216.
Arkader A, et al: Primary musculoskeletal Langerhans cell histiocytosis in children: an analysis for a 3-decade period. J Pediatr Orthop 2009;29:201-207.
Rawlings CE 3rd, Wilkins RH: Solitary eosinophilic granuloma of the skull. Neurosurgery 1984;15:155-161.
Eckardt A, Schultze A: Maxillofacial manifestations of Langerhans cell histiocytosis: a clinical and therapeutic analysis of 10 patients. Oral Oncol 2003;39:687-694.
Eppley BL, et al: Resorbable PLLA-PGA plate and screw fixation in pediatric craniofacial surgery: clinical experience in 1,883 patients. Plast Reconstr Surg 2004;114:850-856, discussion 857.
Imola MJ, et al: Resorbable plate fixation in pediatric craniofacial surgery: long-term outcome. Arch Facial Plast Surg 2001;3:79-90.
Anderson JM, Rodriguez A, Chang DT: Foreign body reaction to biomaterials. Semin Immunol 2008;20:86-100.
Mackool R, Yim J, McCarthy JG: Delayed degradation in a resorbable plating system. J Craniofac Surg 2006;17:194-197, discussion 197-198.
Bergsma EJ, et al: Foreign body reactions to resorbable poly(L-lactide) bone plates and screws used for the fixation of unstable zygomatic fractures. J Oral Maxillofac Surg 1993;51:666-670.
Chu T, Jaffe R: The normal Langerhans cell and the LCH cell. Br J Cancer Suppl 1994;23:S4-S10.
Favara BE, Jaffe R: The histopathology of Langerhans cell histiocytosis. Br J Cancer Suppl 1994;23:S17-S23.
Park SH, et al: Eosinophilic granuloma of the skull: a retrospective analysis. Pediatr Neurosurg 2007;43:97-101.
Ghanem I, et al: Langerhans cell histiocytosis of bone in children and adolescents. J Pediatr Orthop 2003;23:124-130.
Egeler RM, et al: Langerhans cell histiocytosis: fascinating dynamics of the dendritic cell-macrophage lineage. Immunol Rev 2010;234:213-232.
Ng-Cheng-Hin B, et al: Langerhans cell histiocytosis: old disease new treatment. Q J Med 2011;104:89-96.
Ladisch S, Gadner H: Treatment of Langerhans cell histiocytosis - evolution and current approaches. Br J Cancer Suppl 1994;23:S41-S46.
Raney RB Jr, D'Angio GJ: Langerhans' cell histiocytosis (histiocytosis X): experience at the Children's Hospital of Philadelphia, 1970-1984. Med Pediatr Oncol 1989;17:20-28.
Buchmann L, Emami A, Wei JL: Primary head and neck Langerhans cell histiocytosis in children. Otolaryngol Head Neck Surg 2006;135:312-317.
Willman CL, et al: Langerhans'-cell histiocytosis (histiocytosis X) - a clonal proliferative disease. N Engl J Med 1994;331:154-160.
Hadzic N, et al: Recurrence of Langerhans cell histiocytosis in the graft after pediatric liver transplantation. Transplantation 2000;70:815-819.
Etienne B, et al: Relapsing pulmonary Langerhans cell histiocytosis after lung transplantation. Am J Respir Crit Care Med 1998;157:288-291.
Glover AT, Grove AS Jr: Eosinophilic granuloma of the orbit with spontaneous healing. Ophthalmology 1987;94:1008-1012.
Harris GJ, Woo KI: Eosinophilic granuloma of the orbit: a paradox of aggressive destruction responsive to minimal intervention. Trans Am Ophthalmol Soc 2003;101:93-103, discussion 103-105.
Namai T, Yusa H, Yoshida H: Spontaneous remission of a solitary eosinophilic granuloma of the mandible after biopsy: a case report. J Oral Maxillofac Surg 2001;59:1485-1487.
Rajendram R, et al: Biopsy-confirmed spontaneous resolution of orbital Langerhans cell histiocytosis. Orbit 2005;24:39-41.
Pietrzak WS, Sarver DR, Verstynen ML: Bioabsorbable polymer science for the practicing surgeon. J Craniofac Surg 1997;8:87-91.
Eppley BL, Reilly M: Degradation characteristics of PLLA-PGA bone fixation devices. J Craniofac Surg 1997;8:116-120.
Eckelt U, et al: Ultrasound aided pin fixation of biodegradable osteosynthetic materials in cranioplasty for infants with craniosynostosis. J Craniomaxillofac Surg 2007;35:218-221.
Agarwal S, et al: Use of resorbable implants for mandibular fixation: a systematic review. J Craniofac Surg 2009;20:331-339.
Pui CM, Jergesen HE: Femoral involvement by Langerhans cell histiocytosis following total hip arthroplasty: a case report. J Bone Joint Surg Am 2011;93:e98(1-6).
Mokal NJ, et al: Langerhans cell histiocytosis: orbital involvement as an unusual location. Plast Reconstr Surg 2001;107:813-817.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.