Sage Journals: Discover world-class research

Abstract

Aims and background

Histiocytosis X is a condition characterized by an abnormal proliferation of histiocytes with a variable granulomatous and inflammatory component; bone involvement is almost always present. The aim of this study was to define the management of solitary eosinophilic granuloma (EG) of the calvaria in adult patients, in relation to the size and site of the lesion.

Methods

Fourteen patients, ranging in age from 7 to 45 years, with solitary eosinophilic granuloma of the calvaria were surgically treated by craniectomy or curettage and cranioplasty. We subgrouped the lesions into two types: A) lesions localized inside the diploë and/or compressing the cerebral parenchyma below but without dural infiltration; B) lesions with mainly intracranial growth, compressing the cerebral parenchyma and infiltrating the dura. The infiltrated dura mater in type B lesions was replaced with a dural patch. Cranioplasty was performed in lesions with a diameter of 4 cm or more and/or located in aesthetically exposed areas of the skull.

Results

None of the patients died during the study and no local or systemic recurrences were observed during follow-up (min. 3 yrs, max. 8 yrs).

Conclusions

Surgical treatment of patients with isolated EG of the calvaria not only is simple and quick but also allows histological diagnosis of the osteolytic lesion. These patients do not require further adjuvant treatment. Cranioplasty should be performed when the lesion has a diameter of 4 cm or more, when it is located in aesthetically exposed areas of the skull such as the frontal or temporal bones, or when it produces alterations of the normal skull morphology.

Keywords

eosinophilic granuloma calvaria histiocytosis X lytic skull lesion

Get full access to this article

View all access options for this article.

References

Arseni

Danaila

Constantinescu

: Cranial eosinophilic granuloma. Neurochirurgia (Stuttgart), 20: 189, 1977.

Baker

G.S.

Fischer

R.G.

: Eosinophilic granuloma of the skull: Report of four cases, with five years follow-up. Surg. Clin. North. Am., 28: 1057–1070, 1948.

Choux

Gomez

Choux

Vigouroux

R.P.

: Diagnostic and therapeutic problems concerning tumors of the vault. Childs Brain, 1: 207–216, 1975.

Debois

van den Bergh

: Benign tumors of the cranial vault, a report of 12 cases. Clin. Neurol. Neurosurg., 8: 1–12, 1979.

Eriksen

Janinis

Variakojis

Winter

Russell

Marder

Dalcanto

: Primary histiocytosis of the parietooccipital lobe. Hum. Pathol., 19: 611–614, 1988.

Facchin

Aprile

: Istiocitosi-X. Descrizione di un caso clinico ad inusuale presentazione macroscopica e neuroradiologica. Rivista Medica del Friuli, 1: 207–211, 1995

Graif

Pennock

J.M.

: MRI imaging of histiocytosis-X in the central nervous system. AJNR, 7: 21–23, 1986

Gramatovici

D'Angiò

: Radiation therapy in soft-tissue lesions in histiocytosis-X (Langerhans cell histiocytosis). Med. Pediatr. Oncol., 16: 259–262, 1988.

Grundy

Ellis

: Histiocytosis X. A review of the etiology, pathology, staging and therapy. Med. Pediatr. Oncol., 14: 45–50, 1986.

10.

Hufnagel

T.J.

Artiles

Piepmeier

Kier

Kim

J.H.

: Desmoplastic fibroma of parietal bone simulating eosinophilic granuloma. J. Neurosurg., 67: 449–451, 1987.

11.

Jaffe

H.L.

Lichtenstein

: Eosinophilic granuloma of the bone. A condition affecting one, several or many bones but apparently limited to the skeleton and representing the mildest clinical expression of the peculiar inflammatory histiocytosis also underlying “Letterer-Siwe disease” and “Schüller-Christian disease”. Arch. Pathol., 56: 84–102, 1953.

12.

Jelsma

Ross

P.J.

: Tumor-like lesion of the calvaria. Am. Surg., 29: 247–255, 1963.

13.

Lichtenstein

: Histiocytosis X, integration of eosinophilic granuloma bone, “Letterer-Siwe disease”, and “Schüller-Christian disease” as related manifestations of a single nosologic entity. Arch. Pathol., 56: 84–102, 1993.

14.

Lichtenstein

Jaffe

H.L.

: Eosinophilic granuloma of bone with a report of a case. Am. J. Pathol., 16: 595–604, 1940.

15.

Lunardi

Farah

J.O.

Qasho

Puzzilli

Siciliano

Di Stefano

: Primary eosinophilic granuloma invading the skull base: case report and critical review of the literature. Tumori, 82: 397–400, 1996.

16.

Murayama

Numaguchi

Robinson

A.E.

Richardson

D.E.

: Magnetic resonance imaging of calvarial eosinophilic granuloma. J. Comput. Tomogr., 12: 251–252, 1988.

17.

Rawlings

C.E.

Wilkins

R.H.

: Solitary eosinophilic granuloma of the skull. Neurosurgery, 15: 155–161, 1984.

18.

Ruge

J.R.

Tomita

Naidich

Hahn

Melone

D.G.

: Scalps and calvarial masses on infants and children. Neurosurgery, 22: 1037–1041, 1988.

19.

Selfa-Moreno

Arana-Fernandez

Fernandez-Latorre

Diaz-Ramon

Ricart-Rodrigo

Moreno-Flores

: Desmoplastic fibroma of the skull. Case report. J. Neurosurg., 82: 119–120, 1995.

20.

Silvani

Gaetani

Paulli

Bottoni

Spanu

Rodriguez

Baema

: Il trattamento del granuloma eosinofi-lo della teca cranica: presentazione di 4 casi clinici e revisione della letteratura. Bollettino della Società Medico-Chirurgica di Pavia vol. 99, n°1-2: 79–85, 1985.

21.

Slater

J.M.

Swarm

O.J.

: Eosinophilic granuloma of the bone. Med. Ped. Oncol., 8: 83–89, 1980.

22.

Starling

K.A.

Dyer

Silva-Sosa

Komp

Herson

Trueworthy

R.C.

: Chlorambucil in histiocytosis-X. A Southwest Oncology Group study. J. Pediatr., 96: 266–268, 1980.

23.

Starling

K.A.

Fernbach

D.S.

: Histiocytosis. In: Clinical pediatric oncology, 3rd ed., Sutow

(Ed.) C.V. Mosby Company, St. Louis, 1984.

24.

Vanderberg

H.J.

Coley

B.L.

: Primary tumors of the cranial bones. Surg. Gynecol. Obstet., 90: 602–612, 1950.

25.

Yang

J.T.

Chang

C.N.

Lui

T.N.

Y.S.

: Eosinophilic granuloma of the skull - report of four cases. Chang Keng I Hsueh, 16: 257–262, 1993.

26.

Yiannias

J.A.

Brodland

D.G.

: Transcranial eosinophilic granuloma manifested by a subcutaneous scalp mass. Differential diagnosis in children. J. Dermatol. Surg. Oncol., 19 631–634, 1993.

Solitary Eosinophilic Granuloma of the Calvaria

Abstract

Aims and background

Methods

Results

Conclusions

Keywords

Get full access to this article

References