Magnetic resonance imaging of calvarial eosinophilic granuloma with pericranial soft tissue reaction--case report.
ABSTRACT A 4-year-old girl presented with an eosinophilic granuloma in the cranial vault. Magnetic resonance (MR) imaging showed the mass as slightly low intensity on T1- and high intensity on T2-weighted images. The pericranial soft tissue was densely enhanced after gadolinium-diethylenetriaminepenta-acetic acid infusion. The mass was soft and successfully removed. Histological examination disclosed Langerhans' cell histiocytosis. MR imaging is useful for the diagnosis of calvarial eosinophilic granuloma with soft tissue involvement.
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ABSTRACT: The problem with treatments against skull lesions of Langerhans cell histiocytosis (LCH) is that invasions often reach the bones and dura mater, making it difficult to accurately comprehend the range thereof prior to surgery. We herein report that (11)C-methionine positron emission tomography (PET) (Met-PET) carried out prior to surgery was useful in comprehending the spreading of the lesion. A 20-year-old female presented with swelling and dull pain on the left side of the head. A slightly heterogeneously reinforced tumor was observed inside the bone defect in the gadolinium-enhanced T1-wighted image upon magnetic resonance imaging (MRI) and the dura mater contacting the tumor was observed with an enhancing effect. Accumulation was poor in the center of the tumor upon Met-PET, and accumulation with a well-defined border was observed in the border thereof as well as the area adjacent to the brain. Surgical resection was performed; the pathological diagnosis was LCH. An invasion of tumor cells was observed in the dura mater with accumulation observed according to Met-PET. Moreover, the accumulation of tumor cells was observed in the area observed with accumulation inside the bone; however, the center part with poor accumulation lacked tumor cells, with fibrous tissue accounting for most parts. Met-PET was believed to be helpful in comprehending the spreading of the tumor in the surroundings of the brain surface for skull lesions.Surgical Neurology International 02/2014; 5:27. DOI:10.4103/2152-7806.127891 · 1.18 Impact Factor
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ABSTRACT: Langerhans cell histiocytosis is a systemic disease resulting from the oligoclonal proliferation of Langerhans cells, occurring most commonly in children and young adults. The focal form of the disease, also known as eosinophilic granuloma, most frequently involves the calvaria. We present two cases of calvarial eosinophilic granulomas that were surgically removed. These tumors are reputed to have an excellent prognosis, even if local recurrences and systemic dissemination can occur during the follow-up. The authors discuss the pathogenesis and the evolutive profile but also the therapeutic management of solitary eosinophilic granuloma of the calvaria.Neurochirurgie 12/2009; 55(6):555-559. DOI:10.1016/j.neuchi.2009.04.001 · 0.47 Impact Factor
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ABSTRACT: 90% of cases of eosinophilic granuloma (EG) occur in children under ten years of age. It is a rare, benign bone tumor, involving the head and vertebral bones, with a controversial etiology. EG is characterized by either single or multiple lytic-bone lesions. It develops by the accumulation of eosinophils and histiocytes on the medullary layer of the bone. The diagnosis is confirmed pre-operatively with X-rays, bone scintigraphy, CT, MRI and histological examination after surgery. Eosinophilic granuloma does not lead to malignant transformation. Eosinophilic granuloma can be followed up without treatment if there are no symptoms. The treatment of painful lesion can be with surgical curettage of the tumor or local infusion of cortisone. Chemotherapy, radiotherapy and systemic use of cortisone are effective for multiple bone lesions. In this case report, we present a four-year-old male patient admitted to our clinic with complaints of swelling in the right parietal region and local pain.