Eosinophilic granuloma is a rare, benign tumor-like disorder characterized by clonal proliferation of antigen-presenting mononuclear cells of dendritic origin known as Langerhans cells [
1,
2]. It is the most common manifestation of Langerhans-cell histiocytosis (60–80 % cases), accounting for less than 1 % of all bone tumors [
3]. In 80 % of cases it affects children and adolescents [
4,
5]. It can affect any bone in the skeleton; however, bone lesions are more common in the skull, mandible, spine, ribs, and long bones; the femur, humerus and clavicle are the most frequent sites [
6]. The pathogenesis is unclear; viruses such as Epstein-Barr and human herpes virus-6, bacteria, and genetic factors have been implicated [
3,
7,
8]. An immunological dysfunction including an increase of certain cytokines such as interleukin-1 and interleukin-10 in affected patients has also been reported; familial occurrence is very rare [
1,
9]. In the spine, eosinophilic granuloma accounts for 6.5–25 % of all spinal bone tumors [
5,
10‐
16]. The most common location is the thoracic spine followed by the lumbar and the cervical spine [
10,
15,
17‐
20]. Clinical symptoms are often severe and depend on spinal location [
14,
15,
20]. The most common include back or neck pain, tenderness to spinal palpation and restricted range of motion, or torticollis; spinal instability and neurological symptoms are uncommon [
5,
15,
21‐
25]. In the extremities, most lesions are diaphyseal [
7]. The physical examination of the child may be essentially normal. Laboratory findings are usually non-specific except for a moderate and inconsistent rise in erythrocyte sedimentation rate.