Eosinophilic glanuloma of skull in children: reports of 51 cases

Abstract

Objective To investigate the clinical manifestation, diagnosis, treatment and prognosis of skull eosinophilic granuloma. Methods A retrospective analysis was performed on patients with eosinophilic granuloma of the skull who were admitted into Department of Neurosurgery Nanjing Children's Hospital from Jan.2003 to Dec.2011.All clinical data of 51 cases, especially in diagnosis and surgical treatment were analyzed in present study.All patients underwent head CT examination when admitted.Forty-eight patients with solitary skull lesion underwent expanded lesion resection operation.The bone marrow biopsy was performed on 2 patients with multiple skull lesions.The other one case in which lesion invaded the orbital bone got just the lesion biopsy.Every lesion removed from patient's skull underwent the pathological examination after the operation.All patients were transferred to the department of hematology for further treatment. Results In this study, male to female ratio was 2.6:1, with an average age of (3.99±2.96) years old.The most common complaint was that they accidentally discovered the head mass which was enlarged every year.The lesions were mainly located in the parietal bones, followed by frontal bones, occipital bones, temporal bones and orbital bones.There was tenderness in 40 patients (78.4%). Forty-eight cases were transferred to hematology department for further examination.Three cases of them were found to have other parts of the bone lesions.Skull lesion diameters were between 1.1 cm and 6.7 cm.The lesion diameter over 2 cm were 39 cases.All patients had clinical follow-up of 1 to 5 years, with an average of 2.1 years.Forty-five cases with single lesion were transferred to hematology department to receive further treatment, and no relapse was found.Only one patient without further examination and treatment in hematology was found to have new bone lesions in calvaria. Conclusions Surgical resection is an effective treatment to children with skull unifocal eosinophilic granuloma.It is important to do the systemic inspection and follow up the patients with hematologists post-operation. Key words: Skull; Eosinophilic Glanuloma; Treatment