Eosinophilic granuloma of the skull

Case contributed by Dr Mohamed Abdel-Tawab Mohamed


Multiple scalp swellings.

Patient Data

Age: 10 months
Gender: Female

Two osteolytic lesions are seen in the left temporal and left frontal bones. They have beveled edges with wider bone destruction in the outer than the inner skull table.

Case Discussion

Eosinophilic granuloma or histiocytosis X is most often seen in children aged 1 to 15  with the peak incidence from 1 to 4 years of age.

Characteristic appearance in the skull:

  • punched out lytic lesions without sclerotic rim
  • double contour or bevelled edge appearance may be seen due to asymmetrical involvement of the inner versus the outer table (hole within a hole sign), best seen in the VR images.
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Case information

rID: 55125
Published: 16th Dec 2017
Last edited: 23rd Sep 2019
Inclusion in quiz mode: Included
Institution: Assiut University

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