PMC7700074_01
Flowchart of literature review process: exclusion of non-English, non-human literature; exclusion of non-cranial, non extradural, non esionophillic granuloma cases.
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Figure 1 clarifies the review process.
PMC7700074_02
(A) Axial non-contrast CT brain reveals iso-dense subcutaneous scalp lesion, underlying osteolytic bony defect and mixed density extradural lesion. (B) Axial CT head (bone window) shows bevelled bony edges and punched out appearance just posterior to the left coronal suture edge, with an intracranial sequestrum. (C) Post-Contrast axial CT scan images showing irregular dural and mass lesion enhancement.
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Contrast-enhanced CT showed some irregular enhancement (Figure 2).
(A and B) Post-operative MRI (A- T2W axial MR and B-T1W post contrast image) both showing resolution of the extradural haematoma and no evidence of any other lesions.
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Further work up, including skeletal survey, isotope bone scan, chest X-ray, MRI brain (Figure 3) and bone marrow aspiration were performed and revealed no other lesions nor systemic involvement.
(A) Photomicrograph showing a secondary cystic degeneration surrounded by remnant tumour with an extensive haemorrhage. (B) Sheets of large oval cells with abundant pale to eosinophilic cytoplasm, linear grooves and inconspicuous nucleoli. Infiltrates of Langerhans cells, macrophages, lymphocytes, plasma cells and variable eosinophils are seen. (C-E) The tumour cells are positive for Cd1a, S100 and CD68.
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The histopathological findings were suggestive of an eosinophilic granuloma (Figure 4).