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Introduction: We present a case of an advanced granuloma eosinophilicum of maxillary location in a 76 years old man who was admitted to our Department with symptoms of chronic pain in right zygomatic region., Material and Method: We want to lay emphasis on long lasting, low symptomatic development of this kind of tumor and to insist on very carefull otorhinolaryngological and as well radiological examination., Results: According to literature there are many methods used in the therapy of such cases begining with operations, through radiotherapy, the use of steroids or cytostatic drugs and also different combinations of mentioned possibilities. In our case we applied an operation without further radiotherapy and didn't observe any symptoms of recurrence so far., Conclusions: Granuloma eosinophilicum and its multifocal variety e.i. Hand-Schueller-Christian disease require different patterns of treatment depending on its location, tendency to recurrence and the age of affected person.

Introduction: Primary or secondary tumours of spinal cord and vertebral column have various histological structure, various degree of malignancy and various growth dynamics. Such localisation of neoplastic disease creates problems, connected with the risk of irreversible damage of neurological functions. It is essential to make a proper diagnosis very early., Aim: An analysis of initial clinical symptoms and reasons for diagnostic delay in children with neoplasms of the vertebral column and spinal cord. This can facilitate and accelerate diagnostic and therapeutic process., Material and Methods: 20 children treated from 1994 to 2004 in Department of Paediatrics, Haematology, Oncology and Endocrinology in the Medical University of Gdańsk, were investigated. Patients were divided into 2 groups. In group I, there were 11 children with neuroblastoma and peripheral primitive neuroectodermal tumour (PNET). The primary focus of the neoplasm was localised beyond the vertebral column with secondary infiltration of the spinal cord. Nine children were included in-group II, with primary focus in the spinal cord: glioma (2), ependymoma (1), meningioma (1) and localised in bones of the vertebra: osteosarcoma (2), chondrosarcoma (1), Ewing sarcoma (1) and those eosinophilic granuloma (1). Patients were admitted to hospital late. In group I, advanced stage of disease (III and IV) was found in 5, and stage IV in 6 children. In the early stage of the disease in-group II, pain and neurological symptoms were predominant. Duration of symptoms was longer than in-group I. It was from 6 weeks to 12 months. In both groups diagnostic delay was noted in 13 out of 20 patients., Results: In spite of using obligatory treatment protocols diagnostic delay contributed to permanent neurological complications in 65% of patients.

One clinical case of pulmonary eosinophilic granuloma were followed-up during 10 months of chemotherapy. Clinical and radiological symptoms of disease were described. Series of 4 HRCT examinations revealed improvement of pulmonary changes.

Two clinical cases of eosinophilic granuloma with pulmonary manifestation were observed. Therapeutical problems were discussed and corticosteroids and cytostatics were recommended.

A case of eosinophilic granuloma of the lung in a 24 years old male is presented. The initial manifestations were hemoptysis and cough. During hospitalization the bronchoscopy was performed, which revealed granuloma in the right bronchus. Computer tomography showed tumour in the right bronchus, without pulmonary changes characteristic for histiocytosis X. The granuloma was removed by bronchoscopy, but control examination performed after three months showed the residue. Once again residual tumor was removed by bronchoscopy and oral steroids were ordered. Unfortunately the next local residue was observed and the residual tumour was finally removed by thoracotomy. Now patient is free of symptoms.

The author, on the basis of 72 cases of eosinophilic granuloma of the viscerocranium treated in the past 41 years suggested his own terminology. He distinguishes several forms depending on their localization: 1) formae simplices granulomatosis eosinophilici: gingivae, interosseum, tunicae mucosae sinus maxillaris. 2) formae mixtae granulomatosis eosinophilici: gingivo- osseum, gingivo-osseo-sinusale, osseo-vestibulare, osseo-sinusale, sinu-osseo-vestibulare. The first part of the mixed form points the initial place of the focus of eosinophilic granuloma, the latter suggests the direction of expansion of the lesions. The author discussed the methods and results of applied by him therapy.

A case of a 34 year old female with clinical and histological confirmed eosinophilic granuloma causing osteolytic lesions of the mandible and skull and diabetes insipidus. Dyspnea, cough, exercise intolerance with ventilatory disturbances and radiological evidence of interstitial lung disease were believed to be in the course of eosinophilic granuloma. The patient refused lung biopsy and BAL. After starting therapy with corticosteroids all respiratory symptoms improved.

The authors describe current opinions about origin, pathology, histology, diagnosis and treatment of the eosinophilic granuloma. Clinical course, diagnosis and treatment of the own case were discussed.