Eosinophilic granuloma in the temporal bone and skull

Abstract

Eosinophilic granuloma is a benign lytic lesion of bone, probably arising from an abnormal proliferation of histiocytes. It may occur within the temporal bone and be confused with more common disorders such as aural polyps or chronic suppurative otitis media. If untreated, the disease may destroy the bony labyrinth and spread to the middle and posterior cranial fossas. Temporal bone lesions may represent only one manifestation of a more extensive multifocal disorder (i.e., Hand-Schüller-Christian or Letterer-Siwe disease). From 1967 to 1982, 25 patients with eosinophilic granuloma of the skull were treated in the radiation therapy department of The Methodist Hospital in Houston. Six of these patients had disease involving the temporal bone. After analyzing these cases and reviewing the literature, we conclude that the management of the patient with eosinophilic granuloma in the temporal bone requires a diagnosis based on microscopic examination of the affected tissue, a definition of the extent of disease, therapy consisting of biopsy and low-dosage radiotherapy in the unifocal disease, and careful and continued follow-up.