Solitary Eosinophilic Granuloma of Rib: A Case Report and Literature Review

A 10 year old child presented with pain and swelling in the right chest wall since last 2 months. Having no local sign of inflammation x-ray showed a osteolytic lesion in the shaft of 9th rib with thinning of cortex but no sign of pathological fracture or periosteal reaction. MRI of chest show T2 hyper intense and intermediate intense T1 lesion in the 9th rib. Blood investigations were all normal. Clinical and radiological features are non-confirmatory and produce dilemma by giving a basket full of different provisional diagnosis. We have no option other than to go for a biopsy. Biopsy of lesion was consistent with the features of Eosinophilic granuloma. After confirming the diagnosis from histopathology study possible involvement of other body part was ruled out by radiology. On 2 month follow-up, chest x-ray showed the lesion was found to be healing spontaneously with signs of reossificatrion. At 5 months follow X-ray lesion was completely healed radio logically and no symptoms. Patient was follow up for 9 months regularly and there is no recurrence of lesion or any new other site involvement an the child was asymptomatic. A review of available literature was done regarding the various modalities of treatment available for solitary eosinophilic granuloma and their results.