Skull fracture mimicking eosinophilic granuloma

Background

Delayed swelling after skull fractures is an uncommon complication following head trauma in children. Classically, growing skull fractures typically present in patients under 3 years of age with progressive subcutaneous fluid collections, or occasionally with neurologic symptoms. We present the case of a healthy 2-year-old boy with a lytic “punched-out” frontal skull lesion. The child presented 2 months after a minor forehead injury for which no medical attention was sought.

Methods

The skull defect had no associated leptomeningeal cyst or brain herniation. Imaging and presentation were thought to be consistent with eosinophilic granuloma. Histologic findings demonstrated a healing skull fracture.

Results

Cranioplasty was performed, and the patient had an uncomplicated postoperative course.

Conclusions

In this report, we describe our experience with this atypical presentation of a healing skull fracture mimicking a typical eosinophilic granuloma.