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Spontaneous resolution of calvarial eosinophilic granuloma in children
Marcelo Oliveira1, Paul Steinbok, John Wu
1Division of Pediatric Neurosurgery, British Columbia's Children's Hospital, Children and Women's Health Centre, Vancouver, BC, Canada.
Objective:
The recommended treatment for solitary calvarial eosinophilic granuloma (EG) is surgical resection by curettage, craniectomy or craniotomy. The purpose of this study was to describe the spontaneous resolution of calvarial EG and discuss 'observation only' as an option in the management of this condition.
Methods:
A retrospective review was performed of children with calvarial EG seen at a tertiary care children's hospital. Of a total of 17 such patients, four were managed without any intervention and formed the basis of this report.
Results:
In all four patients treated by 'observation only', there was a tender calvarial mass which enlarged rapidly over a few days and then resolved slowly over many weeks. The diagnosis of EG was based on the findings of plain radiographs and/or computed tomography. All masses had resolved by 8 weeks, and the underlying cranial defect filled in spontaneously in all cases. There was no recurrence at follow-up, which ranged from 2 months to 7 years.
Conclusions:
'Observation only' should be considered as a viable option in the management of children with solitary calvarial masses that have the radiographic features of EG. Consideration should be given to delaying surgical intervention to allow time to see if spontaneous resolution occurs.