Solitary Eosinophilic Granuloma of The Parietal Lobe in Infancy with Spontaneous Remission: Case Report with Long-Term Follow-Up and Literature Review

Solitary intracerebral eosinophilic granuloma (EG), the localized form of Langerhans cell histiocytosis in the absence of osseous or systemic involvement, is exceptionally rare, particularly in infancy. We report a 10-month-old male infant presenting with recurrent seizures. Neuroimaging demonstrated an intensely enhancing solitary right parietal intraparenchymal mass on magnetic resonance imaging without bone involvement. Due to the unusual intraoperative appearance encountered biopsy alone was done. Histopathological examination confirmed EG. No systemic disease was detected. The lesion was followed up radiologically and noted to have gradual spontaneous regression, and the patient remains neurologically intact with no recurrence after follow-up for 110 months. A comprehensive review of the literature was performed, identifying previously reported cases of solitary intracerebral lobar EG and without skull or systemic involvement. Twenty-one patients were identified in the literature, including the present case. Seizures were the most common presenting symptom. Surgical resection was the most frequently employed treatment. Outcomes were favorable regardless of treatment modality. Solitary cerebral lobar EG is an exceedingly rare entity with excellent prognosis. In selected cases, biopsy with close radiological surveillance may represent a safe and effective management strategy.