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

Background ContextEosinophilic 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).PurposeThis 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/SettingThe study design was a case report from a tertiary cancer referral center.MethodsPatient records, imaging, and pathology were reviewed.ResultsA 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.ConclusionRadiation therapy is an effective treatment option for sacral EG causing severe axial pain and neural impingement.