• Qian-Dui Chen, Shuang-Zhu Lin, Jie Zhou, Xiao-Xiao Chen, Rui-Tong Yang, Xinyao Wang, Jia-Yi Li, Xiao-Chun Feng, Yu-Shu Liu, Kai Jiang, and Jin-Hua Feng.
• College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, China.
• Medicine (Baltimore). 2023 Jun 30; 102 (26): e34139e34139.

RationaleEosinophilic granuloma (EG) - the most common form of Langerhans cell histiocytosis - occurs rarely, and manifestations with only rib and clavicle involvement are extremely rare. EG symptoms often include pain, swelling, and soft tissue mass. The clinical diagnosis of bone EG is complex, and the differential diagnosis includes Ewing sarcoma, tuberculosis, multiple myeloma, lymphoma, primary bone malignancy, and other osteolytic lesions.Patients ConcernThe patient was an 11-year-old female who found a subcutaneous mass at the junction of the right clavicle and sternum 2 days before presenting at the clinic without apparent triggers. Initially, we considered a subcutaneous cyst or inflammatory mass. Color ultrasound and computed tomography examination revealed osteomyelitis. Finally, the patient was diagnosed with EG after a pathological tissue biopsy, and the child recovered after surgery and anti-infective treatment.DiagnosisThe patient underwent surgery to remove the tumor at a specialist hospital and was diagnosed with EG by pathological examination.InterventionThe patient went to a specialist hospital for surgery to remove the mass and underwent anti-infective treatment.OutcomesThe patient recovered after surgical resection and antibiotic treatment.LessonsIn this report, we emphasize that the clinical presentation of EG in children is not specific. Furthermore, examining age, history, presence of symptoms, and the number of sites is essential to make a correct diagnosis, and a histological examination is necessary to confirm the diagnosis.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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