Successful treatment of a bifocal eosinophilic granuloma of the spine with CT-guided corticosteroid injection

Andreas F. Mavrogenis, Eugenio Rimondi, Giuseppe Ussia, Giuseppe Rossi, Pietro Ruggieri

Research output: Contribution to journalArticle

Abstract

Observation and immobilization is adequate for most patients with spinal eosinophilic granuloma; however, in patients with symptomatic lesions, treatment other than simple observation or biopsy alone is recommended. In view of the benign clinical course of eosinophilic granuloma, a simple, minimally invasive, outpatient treatment with a low complication rate such as computed tomography (CT)-guided intralesional corticosteroid injection may be considered the treatment of choice. This article presents a case of a 21-year-old man with a symptomatic bifocal eosinophilic granuloma at the vertebral body of the L3 vertebra and the left T5 costovertebral joint treated effectively by CT-guided intralesional methylprednisolone injection. To the best of our knowledge, this is the first case of successful treatment of a bifocal eosinophilic granuloma with CT-guided corticosteroid injection. Under general anesthesia and CT guidance, the lesion was located through the right transpedicular approach for the L3 lesion and the left posterolateral approach for the T5 lesion using a biopsy trocar. Tissue sample was retrieved and frozen section biopsy showed eosinophilic granuloma. One intralesional CT-guided injection of 80 mg (2 mL) of methylprednisolone acetate was performed in each lesion. Complications related to the procedure were not observed. The patient was admitted postprocedural for overnight medical evaluation and was discharged from the hospital the next day. Complete resolution of pain was observed 72 hours after the procedure. At 5 years after diagnosis and treatment, the patient is asymptomatic; imaging showed healing of both lesions.

Original languageEnglish
JournalOrthopedics
Volume34
Issue number3
DOIs
Publication statusPublished - Mar 2011

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Eosinophilic Granuloma
Adrenal Cortex Hormones
Spine
Tomography
Injections
Intralesional Injections
Biopsy
Observation
Therapeutics
Methylprednisolone
Frozen Sections
Surgical Instruments
Immobilization
General Anesthesia
Outpatients
Joints
Pain

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Successful treatment of a bifocal eosinophilic granuloma of the spine with CT-guided corticosteroid injection. / Mavrogenis, Andreas F.; Rimondi, Eugenio; Ussia, Giuseppe; Rossi, Giuseppe; Ruggieri, Pietro.

In: Orthopedics, Vol. 34, No. 3, 03.2011.

Research output: Contribution to journalArticle

Mavrogenis, Andreas F. ; Rimondi, Eugenio ; Ussia, Giuseppe ; Rossi, Giuseppe ; Ruggieri, Pietro. / Successful treatment of a bifocal eosinophilic granuloma of the spine with CT-guided corticosteroid injection. In: Orthopedics. 2011 ; Vol. 34, No. 3.
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