Eosinophilic Granuloma

What is eosinophilic granuloma?

An eosinophilic granuloma is a benign bone tumor. It’s the mildest form of Langerhans cell histiocytosis, a rare disease that causes your body to produce too many immune cells. Eosinophilic granulomas usually affect kids under 10. The growths are always benign. This means they’re not a symptom — or cause — of cancer.

Eosinophilic granulomas grow on or near large bones in children’s bodies (most commonly, their skulls). If the granuloma isn’t causing your child symptoms like pain it might not need any treatment. Some growths are removed with surgery.

Who do eosinophilic granulomas affect?

Eosinophilic granulomas can affect anyone, but they’re most common in kids between 5 and 10.

Boys or children assigned male at birth (AMAB) are more likely to develop them.

How common are eosinophilic granulomas?

Eosinophilic granulomas are rare. They’re less than 1% of all bone tumors.

Fewer than 5 per 1 million kids are diagnosed with an eosinophilic granuloma each year.

How does an eosinophilic granuloma affect my child’s body?

Eosinophilic granulomas can grow on any large bone. The growths themselves are hardened collections of immune cells that form a bump on or near your child’s bones. The most common bones eosinophilic granulomas grow on include:

• Skull.
• Pelvis.
• Femur (thigh bone).
• Ribs.
• Humerus (upper arm bone).
• Mandible (jaw bone).
• Spine.

Depending on how big the granuloma is, it can cause symptoms like pain or pressure under your child’s skin.

Many kids never even notice they have one. Eosinophilic granulomas are frequently discovered and diagnosed when children get X-rays for other issues.

What are the symptoms of an eosinophilic granuloma?

Symptoms of an eosinophilic granuloma include:

• Pain.
• Swelling.
• Tenderness in the area.
• Headaches, increased thirst and increased need to pee (also known as diabetes insipidus).
• Stiffness (if the growth is on or near a joint).
• Discoloration on the skin above or near the growth.

What causes eosinophilic granulomas?

Eosinophilic granulomas are a form of Langerhans cell histiocytosis (also called histiocytosis X). Langerhans cell histiocytosis is an autoimmune disease that makes your child’s body produce too many white blood cells that usually fight infections.

Eventually, these extra white blood cells can clump together and form tumors throughout your child’s body.

How are eosinophilic granulomas diagnosed?

Your healthcare provider will diagnose an eosinophilic granuloma with a series of tests, including:

• Lab tests: Blood draws can confirm or rule out other conditions, including some cancers.
• Imaging tests: Your healthcare provider will use a combination of X-rays, MRI, CT scans, ultrasounds and bone scans to take pictures of the granuloma inside of your child. Which tests your child needs depends on where in their body the growth is.
• Biopsy: Your healthcare provider might remove some of the growth with a biopsy to examine it under a microscope.

Your healthcare provider might need several tests to confirm that your child has an eosinophilic granuloma and not other types of tumors or a form of cancer.

How are eosinophilic granulomas treated?

Which treatments your child will need depends on where in their body the eosinophilic granuloma is and if it’s causing them any symptoms.

Treatment for eosinophilic granulomas includes:

• Observation: Many granulomas never cause symptoms and are re-absorbed into kids’ bodies over time. Your healthcare provider will order future tests to make sure the tumor hasn’t changed or grown.
• Steroid injections: Your healthcare provider will inject a corticosteroid into the granuloma. This will shrink it enough to relieve your child’s symptoms.
• Radiation or chemotherapy: Your healthcare provider might recommend radiation therapy or chemotherapy. Eosinophilic granulomas aren’t cancerous, but these treatments can destroy the benign tumor in your child the same way they do cancer cells.
• Surgical removal: Your surgeon will remove the granuloma. Which type of surgery your child needs depends on where in their body the granuloma is.

Eosinophilic granuloma complications

Complications from an eosinophilic granuloma include:

• Increased risks of certain cancers later in life.
• Hearing or vision loss.
• Trouble moving the affected body part.
• Stunted growth.
• Mental health issues like depression or anxiety.

How do I manage my child’s eosinophilic granuloma symptoms?

Your healthcare provider will advise you on how to manage your child’s symptoms. Managing any symptoms your child has depends on how severe the symptoms are and where in their body the eosinophilic granuloma is located.

How soon after treatment will my child feel better?

If your child needs treatment beyond observation, it might take some time for them to feel better. Some treatments — like chemotherapy — take up to a year to work. Surgeries will have a unique timeline, too.

How long it takes your child to feel better depends on where the eosinophilic granuloma grew in their body and which treatments they need to remove it.

Talk to your healthcare provider about your child’s specific recovery time.

What can I expect if my child has an eosinophilic granuloma?

If your child has an eosinophilic granuloma, you should expect them to need consistent check-ups and tests. Even if your child doesn’t have symptoms, your healthcare provider will need to keep an eye on the growth to make sure it’s not changing, growing or spreading.

If your child isn’t experiencing symptoms, they might never need treatment.

How long does an eosinophilic granuloma last?

Most eosinophilic granulomas go away in a year or two. Many of them never cause symptoms.

Will my child need to miss school during treatment?

It depends on which types of treatment your child needs. If your healthcare provider is only monitoring the eosinophilic granuloma, your child probably won’t need to change anything about their daily routine.

Talk to your healthcare provider or surgeon for a list of activities your child should avoid while receiving any treatment.

What is the outlook for eosinophilic granulomas?

Kids with a single growth have a very positive outlook. Most eosinophilic granulomas never cause noticeable symptoms and disappear in a year or two.

When should I see my healthcare provider?

Talk to your healthcare provider right away if your child has any new symptoms, especially if they’re having headaches, trouble seeing or trouble moving. The sooner your healthcare provider diagnoses any changes in your child’s body, the more likely you can rule out cancers and other diseases before they cause serious issues.

What questions should I ask my doctor?

• What tests will my child need?
• How long will the eosinophilic granuloma last?
• How often will they need more tests?
• Which treatments will my child need?

A note from Cleveland Clinic

It can be terrifying to learn your child has a growth inside of their body, but eosinophilic granulomas aren’t cancer. Eosinophilic granulomas might not even cause symptoms, and lots of kids never even notice they have one. Your healthcare provider will walk you through all the steps you’ll need to diagnose and monitor your child’s progress.