Eosinophilic granuloma of the atlas presenting as torticollis in a child.

STUDY DESIGN

This report describes a case of successful surgical treatment of eosinophilic granuloma of the atlas in a 3.5-year-old boy who presented with torticollis.

OBJECTIVE

The purpose of this report was to illustrate the rare clinical presentation of eosinophilic granuloma in the atlas.

SUMMARY OF BACKGROUND DATA

Eosinophilic granuloma, a benign solitary lesion that commonly affects children, has a variable clinical course. Although eosinophilic granuloma has been reported to occur in the cervical spine, there have been only five reported cases of eosinophilic granuloma affecting the atlas. The management of eosinophilic granuloma ranges from observation and immobilization of the cervical spine to surgical excision.

METHODS

The tumor was located on the left lateral mass of the atlas. Biopsy and curettage were performed through an oblique incision through the posterior border of the sternocleidomastoid muscle. A histopathologic evaluation confirmed the diagnosis of eosinophilic granuloma.

RESULTS

The patient tolerated the procedure with no complications, and his torticollis has completely resolved.

CONCLUSION

Eosinophilic granuloma of the atlas initially presented in this patient as torticollis. Biopsy for confirmation of diagnosis and curettage for treatment provided a successful outcome in this patient. We suggest biopsy of the lesion and histopathologic evaluation to confirm the diagnosis in atypical cases.