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J Neurosurg Pediatr. 2013 Jul;12(1):1-5. doi: 10.3171/2013.4.PEDS12482. Epub 2013 May 10.

Nonoperative management of solitary eosinophilic granulomas of the calvaria.

Author information

1
Division of Hematology Oncology, Miami Children's Hospital Cancer Center and Herbert Wertheim College of Medicine, FL 33155, USA. Guillermo.deangulo@mch.com

Abstract

OBJECT:

Solitary eosinophilic granuloma (EG) of the calvaria is most commonly treated with surgical excision. The authors hypothesize that many solitary EGs will resolve without intervention, and observation may be a reasonable option. This study was undertaken to investigate that hypothesis.

METHODS:

The authors reviewed their institutional records and identified 14 cases of solitary calvarial EG. In 6 cases the patients underwent resection based on family and/or neurosurgeon preferences. A strategy of nonoperative management (purposeful observation) was chosen for the other 8 cases. The authors report the clinical course and imaging results in these 8 cases.

RESULTS:

One of the 8 patients underwent surgery 2 months after presentation because of slight enlargement of the lesion and increasing pain. After a median follow-up period of 1 year (range 6-19 months), none of the other patients had required surgery. Five of these 7 patients had pain at presentation. Pain resolved completely in all 5. The remaining 2 remained asymptomatic. Complete resolution of pain was reported in the 5 patients who had pain at presentation. There was complete clinical resolution of the palpable soft-tissue lesion in all 7 cases. Complete radiographic resolution of the lesion was observed in 5 cases and near-complete resolution in the remaining 2.

CONCLUSIONS:

Observation is a safe and reasonable approach in the management of solitary calvarial EG and may prevent unnecessary surgical interventions.

PMID:
23662933
DOI:
10.3171/2013.4.PEDS12482
[Indexed for MEDLINE]
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