Solitary eosinophilic granuloma of the third metacarpal at pediatric age.

Langerhans cell histiocytosis involves disorders previously referred to as "histiocytosis X" (including eosinophilic granuloma of bone, Letterer-Siwe, and Hand-Schüller-Christian syndrome). Eosinophilic granuloma of the hand, especially if solitary, is extremely rare. This is the third pediatric case reported in the literature with solitary eosinophilic granuloma of the hand and the second with metacarpal involvement. The patient's lesion was curetted and the histologic examination showed eosinophilic granuloma. The patient received adjuvant radiotherapy because of continuing mild functional impairment and fracture risk. At 12-month follow-up near complete recovery of the lesion was observed. Radiologically, there was sclerosis and remodeling of the third metacarpal. The patient is disease-free at 26 months.