Eosinophilic Granuloma of the Skull: A Retrospective Analysis

Abstract

Background: The authors describe 9 cases of children with eosinophilic granuloma (EG) of the skull and report on their clinical manifestations, treatment, and prognosis. Method: Nine consecutive patients were diagnosed as EG of the skull and confirmed pathologically between 1996 and 2005. In the present study, multi- and single-system Langerhans’ cell histiocytosis without skull involvement were excluded. Patients with EG of the skull were divided into two groups: (1) those with only a single bone lesion and those with (2) multiple bone lesions. Surgical removal was performed between 2 and 10 years of age (mean, 4.2 years). Results: Eight (88.9%) of the study subjects were found to have a single bone lesion at diagnosis, and 1 had multiple bone lesions. Seven patients had a painless skull mass and 2 patients had a painful skull mass. Total removal was performed in all 9 patients. Eight patients received postoperative chemotherapy or indomethacin as adjuvant therapy. Of the 8 patients who received adjuvant therapy, 4 were treated with indomethacin and the remaining 4 received methotrexate-based chemotherapy. Eight patients did not experience EG recurrence, however, 1 patient developed additional lesions 2 years after surgical excision. Conclusions: EG of the skull is a clinicopathological entity with a good outcome. However, therapies and prognoses are dependent on age at diagnosis and the number of bony involvements.

Cranial unifocal Langerhans cell histiocytosis in children

“…Eosinophilic granuloma arises from an abnormal proliferation of histiocytes. Most commonly presents as a solitary lesion in the skull, whereas femur, mandible, ribs, pelvis, and spine are other common locations [2][3][4]. In our series, only one patient had a secondary lesion in the iliac fossa.…”

“…Nevertheless, in our series, the size of the defect was small, and no bone reconstruction was needed. The role of radiotherapy is dubious and is usually reserved for cases of recurrent tumor [4]. Adjuvant chemotherapy has been used, but our results showed that chemotherapy may not be necessary.…”

“…However, acute presentation of a solitary EG with an epidural hematoma has been described [5,6]. The causes of epidural hematoma in these cases were suggested to be a rupture of the tumor cyst communicating with the epidural vein and the sinus pericranii and intratumoral bleeding rupturing into the epidural space [4].…”

Resorption of PDLLA Plates as a Nidus for Recurrent Langerhans Cell Histiocytosis

“…It is characterized by the proliferation of cells resembling the antigen-presenting Langerhans cells normally present in the epidermis, lymph nodes, thymic epithelium and bronchial mucosa [14,15]. The lesions typically occur in one or more organ systems, most typically bone [2,6,16,17] and skin (dermis), as well as viscera, e.g. lung and liver [18,19].…”

An Unusual Case of Solitary Swelling over Forehead: Think Eosinophilic Granuloma

“…EG is characterised by single or multiple lesions commonly involving long bones, skull, spine, ribs, mandible etc. [2] and predominantly affects children, adolescents, and young adults. Solitary lesions are more common than multiple lesions.…”