Eosinophilic Granuloma in an Adult Thoracic Spine: A Case Report

ABSTRACT

In adults, eosinophilic granuloma of the spine is a rare, benign osteolytic lesion. In a case of a 33-year-old man with neurologic deterioration, magnetic resonance imaging (MRI) showed an osteolytic lesion of the T4 vertebra with spinal cord compression. Involvement of the left pedicle of T4 and paravertebral soft tissue was also observed. On the second day after a fluoroscopic percutaneous needle biopsy, the patient abruptly developed paraplegia. He underwent an emer- gency operation with posterior decompression, followed by anterior stabilization and corpectomy several days later. Histological examination of the tissue, including the paravertebral soft tissue, showed features of eosinophilic granuloma. After surgery, the patient returned to full activity. Eosinophilic granuloma of the spine is a rare disease in adults and may affect all the vertebral structures. Surgical treatment seems necessary for cases specifically involving progressive neurologic deficits.