Puzzilli F, Mastronardi L, Farah J O, Ruggeri A, Lunardi P
Department of Neurological Sciences, Second Chair of Neurosurgery, University of Rome La Sapienza, Italy.
Tumori. 1998 Nov-Dec;84(6):712-6. doi: 10.1177/030089169808400620.
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.
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.
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).
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.
组织细胞增多症X是一种以组织细胞异常增殖为特征的疾病，伴有不同程度的肉芽肿和炎症成分；几乎总会出现骨骼受累。本研究的目的是明确成年患者颅骨孤立性嗜酸性肉芽肿（EG）的治疗方法，该方法与病变的大小和部位相关。
14例年龄在7至45岁之间的颅骨孤立性嗜酸性肉芽肿患者接受了颅骨切除术或刮除术及颅骨成形术治疗。我们将病变分为两种类型：A）病变局限于板障内和/或压迫下方脑实质但无硬脑膜浸润；B）主要为颅内生长的病变，压迫脑实质并浸润硬脑膜。B型病变中浸润的硬脑膜用硬脑膜补片替代。直径4厘米或更大和/或位于颅骨美观暴露区域的病变进行颅骨成形术。
研究期间无患者死亡，随访期间（最短3年，最长8年）未观察到局部或全身复发。
颅骨孤立性EG患者的手术治疗不仅简单快捷，还能对溶骨性病变进行组织学诊断。这些患者无需进一步的辅助治疗。当病变直径4厘米或更大、位于颅骨美观暴露区域（如额骨或颞骨）或导致正常颅骨形态改变时，应进行颅骨成形术。
