Sacral Spine Eosinophilic Granuloma in an Adult Patient: A Case Report of Unusual Age and Location

  • Ümit Akın Dere Mehmet Akif İnan Training and Research Hospital
  • Ayfer Aslan Şırnak State Hospital
  • Ahmet Memduh Kaymaz Gazi University
Keywords: Eosinophilic granuloma, Langerhans’ cell histiocytosis, histiocytosis X, spine tumor


Eosinophilic granuloma one of a triad of diseases under Langerhans’ cell histiocytosis as known as Histiocytosis X, is a rare disorder characterized with uncontrolled proliferation of histiocytes, mostly seen among children and adolescents instead of adults. Although the clinical picture is well defined, there are still unclear aspects on etiology, histology and prognosis. Here we are presenting our experiences on a case of eosinophilic granuloma interestingly in an adult patient. She was admitted with back and hip pain. After her diagnosis of sacral spine osteolytic tumor, the biopsy was performed in our clinic and her histopathology was resulted as eosinophilic granuloma. In this paper we are presenting the clinical and hystopathological features of esonophilic granuloma. We aimed to contribute an additional data to the literature on eosinophilic granuloma presented with an atypical localization and age. According to current literature, there are only few reports on both adults and sacrum affected with eosinophilic granuloma.

Author Biographies

Ümit Akın Dere, Mehmet Akif İnan Training and Research Hospital
Mehmet Akif İnan Training and Research HospitalDepartment of NeurosurgeryMD
Ayfer Aslan, Şırnak State Hospital
Şırnak State HospitalDepartment of NeurosurgeryMD
Ahmet Memduh Kaymaz, Gazi University
Gazi University School of MedicineDepartment of NeurosurgeryProf.


Ueda Y, Murakami H, Demura S, Kawahara N, Tomita K, Tsuchiya H. Eosinophilic granuloma of the lumbar spine in an adult. Orthopedics. 2012 Dec;35:e1818-21.

Baillet A1, Grange L, Lafaix PA, Gaudin P, Juvin R. Radiculopathy as a manifestation of Langerhans' cell histiocytosis. Joint Bone Spine, 74, 2007;190-3

Bilge T, Barut S, Yaymaci Y, Alatli C. Solitary eosinophilic granuloma of the lumbar spine in an adult. Case report. Paraplegia. 1995;33:485–7

Rimondi E, Mavrogenis AF, Rossi G, Ussia G, Angelini A, Ruggieri P. CT-guided corticosteroid injection for solitary eosinophilic granuloma of the spine. Skeletal Radiol. 2011;40:757-64.

Cañadell J, Villas C, Martinez-Denegri J, Azcarate J, Imizcoz A. Vertebral eosinophilic granuloma. Long-term evolution of a case. Spine (Phila Pa 1976). 1986; 11:767-9.

Reddy PK, Vannemreddy PS, Nanda A. Eosinophilic granuloma of spine in adults: a case report and review of literature. Spinal Cord. 2000; 38:766-8.

Oberman HA. A clinicopathologic study of 40 cases and review of the literature on eosinophilic granuloma of bone. Hand-SchullerChristian disease and Letterer-Siwe disease. Pediatrics. 1961; 28:307-27.

Nakamura H, Nagayama R. Eosinophilic granuloma presenting with local osteolysis in an adult lumbar spine. J Clin Neurosci. 2008; 15:1398-400.

Kumar A. Eosinophilic granuloma of the spine with neurological deficit. Orthopedics. 1990;13:1310–2

Villas C, Martínez-Peric R, Barrios RH, Beguiristain JL. Eosinophilic granuloma of the spine with and without vertebra plana: long-term follow-up ofsix cases. J Spinal Disord. 1993;6:260-8.

Raab P, Hohmann F, Kühl J, Krauspe R. Vertebral remodeling in eosinophilic granuloma of the spine. A long-term follow-up. Spine (Phila Pa 1976), 1998;23:1351-4.

David R, Oria RA, Kumar R, et al. Radiographic features of eosinophilic granuloma of bone. AJR Am J Roentgenol 1989;153:1021–6.

V Y, E SK, S N B, A K, Sekhar MS. Solitary extragnathic langerhans cell histiocytosis - a rare case. J Clin Diagn Res. 2015;9:ZD22-3.

Islinger RB, Kuklo TR, Owens BD, Horan PJ, Choma TJ, Murphey MD, et al. Langerhans cell histiocytosis in patients older than 21 years. Clin Orthop 2000;379:231e5

Sheila W, Maarten E. Langerhans cell histiocytosis: update for the pediatrician. Curr Opin Pediatr. 2008;1:23-9.

Wilner D. Radiology of bone tumors and allied disorders, vol. 2. Philadelphia: Saunders, 1982.