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Eosinophilic granuloma of skull vault

Case contributed by Vinay V Belaval
Diagnosis almost certain

Presentation

History of recent fall. Headache.

Patient Data

Age: 5 years
Gender: Female

Brain

mri

T2 & FLAIR hyperintense and T1 isointense intradiploic lesion is seen in the left frontal bone showing facilitated diffusion and intense heterogeneous enhancement measuring 2.9 x 0.5 x 2.0 cms (AP x TR x CC). On CT images (done elsewhere- images not shown), the lesion appears lytic without sclerotic borders and indistinct inner/outer tables. There is adjacent left frontal pachymeningeal enhancement. There is thin enhancing extracalvarial soft tissue measuring 2.0 mm in thickness and 2.8 cms in length.

No other calvarial lesions.

Supratentorial and infratentorial brain parenchyma appears normal.

Case Discussion

Possibility of eosinophilic granuloma was raised considering the imaging features. The patient underwent excision biopsy of the lesion. Histopathological examination confirmed the lesion to be eosinophilic granuloma.

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