전두골에 발생한 호산구성육아종의 치험례

A Case Report of Eosinophilic Granuloma in the Frontal Bone

  • 심승현 (한림대학교 의과대학 성형외과학교실) ;
  • 정철훈 (한림대학교 의과대학 성형외과학교실) ;
  • 장용준 (한림대학교 의과대학 성형외과학교실)
  • Shim, Seung-Hyun (Department of Plastic and Reconstructive Surgery, College of Medicine, Hallym University) ;
  • Chung, Chul-Hoon (Department of Plastic and Reconstructive Surgery, College of Medicine, Hallym University) ;
  • Chang, Yong-Joon (Department of Plastic and Reconstructive Surgery, College of Medicine, Hallym University)
  • 발행 : 2010.11.26

초록

Purpose : Eosinophilic granuloma is a rare benign tumor that is characterized histologically by the presence of destructive granulomas containing numerous Langerhans, cells. The most common presentation of eosinophilic granuloma is a painful, immobile scalp mass in the frontal and parietal bones occurring predominantly in children and adolescents or young adults. We report a representative case of eosinophilic granuloma. Methods : A 16-year-old woman complained of an enlarging fixed scalp mass without pain and tenderness which measured $3{\times}4.5cm$ at the frontal area, which had been found incidentally 2 months before. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion. The tumor and surrounding bony edges were completely removed via a bicoronal approach. The bony defect was reconstructed with bone cement. Results : The tumor was involved frontal bone and dura mater. We confirmed the tumor by the documentation of Birbeck's granules by electron microscopy. There is no evidence of local recurrence during postoperative 1.5 years. Conclusion : The present case shows the characteristic feature of frontal bone involvment of the eosinophilic granuloma. The prognosis of eosinophilic granuloma depend on age at diagnosis and number of bones involved. We consider that best choice of treatment for eosinophilic granuloma is surgical excision.

키워드

참고문헌

  1. Park SH, Park JC, Hwang JH, Hwang SK, Hamm IS, Park YM. Eosinophilic granuloma of the skull: a retrospective analysis. Pediatr Neurosurg. 2007;43:97-101. https://doi.org/10.1159/000098380
  2. Alexiou GA, Mpairamidis E, Sfakianos G, Prodromou N. Cranial unifocal Langerhans cell histiocytosis in children. J Pediatr Surg. 2009;44:571-574. https://doi.org/10.1016/j.jpedsurg.2008.07.005
  3. Lee YS, Kwon JT, Park YS. Eosinophilic granuloma presenting as an epidural hematoma and cyst. J Korean Neurosurg Soc. 2008; 43:304-306. https://doi.org/10.3340/jkns.2008.43.6.304
  4. Simanski C, Bouillon B, Brockmann M, Tiling T. The Langerhans' cell histiocytosis(eosinophilic granuloma) of the cervical spine: a rare diagnosis of cervical pain. Magn Reson Imaging. 2004;22:589-594. https://doi.org/10.1016/j.mri.2004.01.006
  5. Linchtenstein L, Jaffe HL. Eosinophilic granuloma of bone with report of a case. Am J Pathol. 1940;16:595-604.
  6. Golla SK, Kavanagh EC. MRI, CT, scintigraphic and histological feature of a vanishing scapular eosinophilic granuloma. Ir J Med Sci. 2009;178:107-110. https://doi.org/10.1007/s11845-008-0133-3