Spinal cord compression by eosinophilic granuloma of the cervical spine. Case report and review of the literature

Abstract

Eosinophilic granuloma is an uncommon lesion, often self-limiting. A location in the spine is rare; until now, only 35 cases have been reported. MRI is the most effective diagnostic technique, although conventional X-ray can also be useful as a first approach. Therapy consists of immobilization of the patients, surgery and chemotherapy as required by to the clinical findings of the lesion. The role of radiotherapy is still controversial. The authors describe the fourth case of eosinophilic granuloma of the cervical spine with neurological symptoms reported in literature.

Solitary eosinophilic granuloma of the adult lumbar spine

“…This lesion is most common in children; 80% of the patient are below 10 years old [9]. The diagnosis of spinal EG is based on clinical features, radiologic imaging studies and histopathologic examination.…”

“…Solitary EG is usually a self-limiting disorder, and spontaneous healing of the lesion is possible [9]. In the literature, high-evidence studies about treatment of EO are not described.…”

Langerhans cell histiocytosis of the cervical spine in an adult: a case report

“…The lesions of LCH are most often osseous and frequently occur in the skull. Cervical spinal involvement has been reported in only a handful of cases in the literature (4,5,8,10,11).…”

Autologous stem cell transplantation for refractory Langerhans' cell histiocytosis

“…Some authors recommend conservative treatment with biopsy and immobilization and the use of steroids. 6 Although patients with localized disease may have an excellent outcome with minimal or no treatment, a significant proportion of patients with disseminated disease may undergo progression to a fatal outcome despite chemotherapy 5 and immunotherapy. 6 Since LCH derives from hyperactivation and proliferation of macrophage progeny cells, there is a rationale for the use of allogeneic BMT in treating advanced, high-risk or resistant LCH.…”

“…6 Although patients with localized disease may have an excellent outcome with minimal or no treatment, a significant proportion of patients with disseminated disease may undergo progression to a fatal outcome despite chemotherapy 5 and immunotherapy. 6 Since LCH derives from hyperactivation and proliferation of macrophage progeny cells, there is a rationale for the use of allogeneic BMT in treating advanced, high-risk or resistant LCH. 7,8 In particular, the successful allogeneic BMT performed by Ringden et al 8 casts new light on LCH patients failing other therapeutic approaches.…”