Thoracic eosinophilic granuloma in a 23-month-old child: a rare case and literature review.

Eosinophilic granuloma (EG) is the most benign and localized form of Langerhans cell histiocytosis (LCH), a rare disorder. Spinal involvement is uncommon, particularly in very young children; Methods: In this report, we present a rare case of a 23-month-old boy with progressive neck deviation and difficulty walking following an unwitnessed fall. Imaging revealed a lytic lesion causing complete collapse of the T1 vertebral body (vertebra plana) with soft tissue extension and spinal cord compression. The patient underwent urgent posterior spinal instrumentation from C7 to T2, tumor debulking, spinal cord decompression, and biopsy; Results: Histopathological examination confirmed the diagnosis of EG (LCH). Postoperatively, the patient showed marked neurological improvement without complications; Conclusion: This case emphasizes the importance of considering EG in the differential diagnosis of spinal lesions in very young children and highlights the challenges in its diagnosis and management. The case is complemented by a focused review of pediatric spinal EG, outlining clinical presentation, diagnostic approach, and management strategies..