Vivek Sharma, Ravinder Singh, Ashwani Ummat, Amit Mittal, Mahesh Gupta.
Eosinophilic granuloma in shaft of tibia: a rare entity.
J Pak Med Students Jan ;2(4):140-3.

BACKGROUND- Eosinophilic granuloma is a rare tumor of flat bones usually presenting in children. The clinical manifestations as well as radiological features of eosinophilic granuloma are highly variable and are often a diagnostic dilemma. We present here a case of eosinophilic granuloma localized to the tibial shaft, which was managed successfully by excision and curettage without bone grafting. CASE REPORT- An eight-year-old girl presented with swelling and pain in the left tibia. On tibial X-ray, a well demarcated 5 to 6 centimeter oval radiolucency within the shaft of upper third of left tibia with sclerosis of medial cortex was seen. Magnetic Resonance Imaging (MRI) showed a 6 centimeter hypointense lesion in the medulla of the medial aspect of tibial shaft on T1W sequence. This lesion was hyperintense on T2 and STIR sequences with surrounding bone marrow edema and mild cortical thinning. In addition, there was no soft tissue involvement outside the bone. Patient was taken to the operation theatre for excision and biopsy. Histopathological examination was consistent with eosinophlic granuloma. Postoperatively, wound and bony defect healed completely, both radiologically and clinically. CONCLUSION- Eosinophilic granuloma is usually diagnosed on histopathology, and open biopsy along with curettage is the preferred form of treatment. However, recurrence can occur even after treatment.

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