Eosinophilic granuloma of the sacrum treated with radiation therapy: a case report

Abstract Background Context Eosinophilic granulomas (EGs) of the sacrum have been reported in fewer than 10 patients. Treatment algorithms for these tumors remain poorly defined; there are no reports of treating solitary sacral EG with radiation therapy (RT). Purpose This study aimed to describe the presentation, treatment, and outcome of sacral EG in an adult patient with intractable pain and radiculopathy, treated in a novel fashion with RT. Study Design/Setting The study design was a case report from a tertiary cancer referral center. Methods Patient records, imaging, and pathology were reviewed. Results A 35-year-old man received 20 Gy of radiation to his S1 EG lesion. He subsequently developed vertebra plana of S1 causing symptomatic L5–S1 stenosis, but 15 months after RT treatment was free of pain or tumor recurrence. Conclusion Radiation therapy is an effective treatment option for sacral EG causing severe axial pain and neural impingement.