Eosinophilic granuloma of the atlas presenting as torticollis in a child.
METHODS
This report describes a case of successful surgical treatment of eosinophilic granuloma of the atlas in a 3.5-year-old boy who presented with torticollis.


OBJECTIVE
The purpose of this report was to illustrate the rare clinical presentation of eosinophilic granuloma in the atlas.


BACKGROUND
Eosinophilic granuloma, a benign solitary lesion that commonly affects children, has a variable clinical course. Although eosinophilic granuloma has been reported to occur in the cervical spine, there have been only five reported cases of eosinophilic granuloma affecting the atlas. The management of eosinophilic granuloma ranges from observation and immobilization of the cervical spine to surgical excision.


METHODS
The tumor was located on the left lateral mass of the atlas. Biopsy and curettage were performed through an oblique incision through the posterior border of the sternocleidomastoid muscle. A histopathologic evaluation confirmed the diagnosis of eosinophilic granuloma.


RESULTS
The patient tolerated the procedure with no complications, and his torticollis has completely resolved.


CONCLUSIONS
Eosinophilic granuloma of the atlas initially presented in this patient as torticollis. Biopsy for confirmation of diagnosis and curettage for treatment provided a successful outcome in this patient. We suggest biopsy of the lesion and histopathologic evaluation to confirm the diagnosis in atypical cases.
Ngu
Bonaventure B
BB
Department of Orthopaedic Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
Khanna
A Jay
AJ
Pak
Shane S
SS
McCarthy
Edward F
EF
Sponseller
Paul D
PD
D002437:Cefazolin / Q000627:therapeutic use; D001270:Cervical Atlas / Q000000981:diagnostic imaging* / Q000473:pathology; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003475:Curettage; D003646:Debridement; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination; D004803:Eosinophilic Granuloma / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D020802:Epidural Abscess / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D013180:Sprains and Strains / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000209:etiology*; D014747:Vinblastine / Q000008:administration & dosage / Q000627:therapeutic use; D014972:Xanthogranuloma, Juvenile / Q000150:complications / Q000188:drug therapy
D014747:Vinblastine; D002437:Cefazolin; D011241:Prednisone