A case of occipital eosinophilic granuloma (EG) presenting as right occipital throbbing headache with a “bump” is reported. Even if cranial X-rays and CT scan showed a typical lytic lesion, to make a definite diagnosis of EG histological examination with immunohistochemical detection of S-100 and CD1a antigens was necessary. A total bone scintigraphy ruled out other bone lesions. Treatment of EG depends on the extent of the disease at the time of diagnosis. When no systemic disease is found some authors suggest “wait and see” management. Twelve months after surgery our patient had no recurrences.
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