Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2011 Feb;27(2):76-9. doi: 10.1016/j.kjms.2010.05.004. Epub 2011 Feb 12.
Eosinophilic granuloma (EG) refers to the most common and benign form of the disorder known as Langerhans' cell histiocytosis. The disease is typically found in children and adolescents and rarely affects adults. We present a case of EG in the occipital bone in a 36-year-old man, who visited our hospital with the chief complaint of left occipital palpable tumor mass with local tenderness and pain for one month. An X-ray of the skull revealed a rounded osteolytic lesion. A computed tomography scan revealed a shadow of soft tissues in the left occipital site involving the entire thickness of the calvaria, which was indicative of marked destruction of the bone. The soft mass was successfully removed. The margins of the skull lesion were excised, and cranioplasty was performed simultaneously with bone cement. A definitive diagnosis of EG was made by histopathology and immunohistochemical detection of S-100 antigen in the tissue samples. With respect to management, we believe surgery is the best option for most accessible cranial lesions of EG. A cranioplasty with bone cement or autologous bone can be performed in the same session to repair the cranial defect.
嗜酸性肉芽肿（EG）是朗格汉斯细胞组织细胞增生症（Langerhans' cell histiocytosis）中最常见和良性的形式。这种疾病通常发生在儿童和青少年中，很少影响成年人。我们报告了一例发生在 36 岁男性枕骨的 EG 病例，该患者因左枕部可触及的肿块伴局部压痛和疼痛 1 个月就诊于我院。颅骨 X 线片显示为圆形溶骨性病变。计算机断层扫描（CT）显示左枕部软组织阴影累及颅骨全层，提示骨明显破坏。成功切除了软组织肿块。颅骨病变的边缘被切除，同时用骨水泥进行了颅骨成形术。组织样本的组织病理学和 S-100 抗原免疫组化检测明确诊断为 EG。对于治疗，我们认为手术是大多数可触及的 EG 颅骨病变的最佳选择。可在同一手术中使用骨水泥或自体骨进行颅骨成形术以修复颅骨缺损。
