1
|
Su H, Gong Y, Chen L, Zhou H, Huang H, Yu S, Wang C, Tong P, Xu T. Xanthoma combining osteonecrosis in knee joint: a case report. BMC Musculoskelet Disord 2024; 25:666. [PMID: 39182060 PMCID: PMC11344287 DOI: 10.1186/s12891-024-07776-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024] Open
Abstract
Xanthoma typically occurs in the subcutaneous tissues, with rare cases of xanthoma in the joints. However, the case of knee joint osteonecrosis combined with xanthoma is even more uncommon. In this article, we described a 50-year-old female patient who suffered xanthoma in the knee joint on the basis of osteonecrosis of the knee joint. The primary clinical symptoms were knee joint pain and limited mobility. The patient initially received conventional treatment for osteonecrosis. However, there was no significant improvement. Later, we found a synovial xanthoma in the patient's knee. Finally, she underwent arthroscopic excision of the knee joint synovial xanthoma. Following the procedure, her VAS score decreased from 7 to 2, and knee joint mobility increased from 10-103° to 10-140°. Through our follow-up, the patient did not exhibit symptom recurrence. This case is valuable as it provides a feasible therapeutic approach for future clinical applications.
Collapse
Affiliation(s)
- Hai Su
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Yichen Gong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Lei Chen
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Haojing Zhou
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Hua Huang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Shengxu Yu
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Chundan Wang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Peijian Tong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China
| | - Taotao Xu
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Hangzhou, Zhejiang Province, 310053, China.
| |
Collapse
|
2
|
Georgiev A, Genova S, Uchikov P, Kraev K, Kraeva M, Chakarov D, Uchikov A. Solitary primary intraosseous xanthoma of the mandible in a 15-year-old boy: a case report. J Med Case Rep 2024; 18:225. [PMID: 38711147 PMCID: PMC11075217 DOI: 10.1186/s13256-024-04534-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor. CASE REPORT A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods. CONCLUSION The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis.
Collapse
Affiliation(s)
- A Georgiev
- Department of Maxillo Facial Surgery, Multiprofile Hospital for Active Medical Treatment "Sv. Panteleimon" Plovdiv, Plovdiv, Bulgaria
| | - S Genova
- Department of General and Clinical Pathology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - P Uchikov
- Department of Special Surgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Krasimir Kraev
- Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 15A Vasil Aprilov Boulevard, Plovdiv, 4000, Bulgaria.
| | - M Kraeva
- Department of Otorhinolaryngology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - D Chakarov
- Department of Propaedeutics of Surgical Diseases, Section of General Surgery, Faculty of Medicine, Medical University of Plovdiv, 4002, Plovdiv, Bulgaria
| | - A Uchikov
- Department of Special Surgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| |
Collapse
|
3
|
Mottola E, Adotti F, Pernazza A, Della Rocca C, D'Amati G, Nardis P, Vannucci J, Bassi M, Venuta F, Anile M. Xanthoma of rib: a case report and review of the literature. J Cardiothorac Surg 2023; 18:205. [PMID: 37400894 PMCID: PMC10318816 DOI: 10.1186/s13019-023-02315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/28/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Xanthomas are well-circumscribed benign proliferative lesions seen mainly in soft tissues. Usually, they are found in hyperlipidemia and familial hyperlipoproteinemia. Histologically, are characterized by macrophage-like mononuclear cells, multinucleated giant cells and abundant foam cells. The bone involvement, however, is notoriously rare and rib localization is extremely rare. CASE PRESENTATION A 55-year-old man performed a chest X-ray and a subsequent chest Computed Tomography scan showing a rib lesion that was surgically removed and a diagnosis of rib xanthoma was made. The patient presented an unknown condition of hyperlipidemia. CONCLUSION Rib xanthoma can be discovered accidentally and can be helpful in identifying an unrecognized condition of hyperlipidemia.
Collapse
Affiliation(s)
- Emilia Mottola
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Flavia Adotti
- Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy
| | - Angelina Pernazza
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy
| | - Carlo Della Rocca
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino-Sapienza University, Latina, Italy
| | - Giulia D'Amati
- Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Rome, Italy
| | - Piergiorgio Nardis
- Interventional Radiology Section of Department of Radiological, Oncological, and Anatomopathological, Sciences of Policlinico Umberto I of Rome, Sapienza University of Rome, Rome, Italy
| | - Jacopo Vannucci
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| | - Massimiliano Bassi
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Anile
- Division of Thoracic Surgery and Lung Transplant, AOU Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
| |
Collapse
|
4
|
Primary Mandibular Condyle Xanthoma: Case Report and Literature Review. REPORTS 2023. [DOI: 10.3390/reports6010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Bone xanthoma is a rare benign primary bone lesion histologically characterized by sheets of foamy cells which are macrophages with a cytoplasm filled with droplets of fat. It is usually associated with endocrine or metabolic diseases, in the absence of which the lesion is called primary xanthoma. Because of the lack of pathognomonic radiologic and clinical features, they require a differential diagnosis with a broad spectrum of lesions with a varying degree of malignant potential. We describe a case of primary mandibular xanthoma of a 16-year-old girl without typical cutaneous manifestations and alterations in lipid values. The temporomandibular joint involvement at the mandibular condyle is peculiar in the case described here. We present even a qualitative systematic review of the literature on primary xanthoma of the jaws in others to draw up treatment guidelines.
Collapse
|
5
|
Primary intraosseous xanthoma of the mandible – A case report, novel approach to removal, and review of the literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
6
|
Argie D, Lauren C, Malelak EB. Bilateral frontal intracranial xanthoma associated with type II hyperlipidemia in a 42-year-old woman: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2021; 2:CASE21465. [PMID: 36061096 PMCID: PMC9435564 DOI: 10.3171/case21465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/01/2021] [Indexed: 11/14/2022]
Abstract
BACKGROUND Xanthoma is a granulomatous lesion that develops from leakage of circulating serum lipoprotein into the surrounding tissue. An isolated intracranial xanthoma is rarely reported and usually misdiagnosed. Intracranial xanthoma is also rarely found in patients with hyperlipidemia. To the best of the authors’ knowledge, no previous studies and literature have reported bilateral involvement of intracranial xanthoma in the frontal lobe. OBSERVATIONS The authors reported an unusual case of bilateral involvement of intracranial xanthoma in the frontal lobe with associated type II hyperlipidemia in a 42-year-old woman. Macroscopically, the tumor had an appearance of greyish-yellow color with a brittle, solid consistency. Histopathological examination revealed numerous lipid-laden macrophages surrounded by a cystic, necrotic, partially hemorrhagic area, with some parts consisting of hemosiderophages and proliferative capillary blood vessels. The histopathological findings indicated the characteristics of xanthoma. LESSONS Bilateral frontal intracranial xanthoma with associated type II hyperlipidemia is an unusual finding. Despite its rarity and wide variety of radiological presentations, it should be considered one of the differential diagnoses of lesions that develop intracranially and intraaxially. Confirmation with histopathological examination is needed to exclude from other differential diagnoses.
Collapse
Affiliation(s)
- Donny Argie
- Department of Neurosurgery, Prof. Dr. W. Z. Johannes Kupang Regional General Hospital, Kupang, East Nusa Tenggara, Indonesia
| | - Christopher Lauren
- Department of Neurosurgery, Prof. Dr. W. Z. Johannes Kupang Regional General Hospital, Kupang, East Nusa Tenggara, Indonesia
| | - Elric B. Malelak
- Department of Neurosurgery, Prof. Dr. W. Z. Johannes Kupang Regional General Hospital, Kupang, East Nusa Tenggara, Indonesia
| |
Collapse
|
7
|
Zhimin W, Hui W, Fengtao J, Wenjuan S, Yongrong L. Clinical and serum lipid profiles and LDLR genetic analysis of xanthelasma palpebrarum with nonfamilial hypercholesterolemia. J Cosmet Dermatol 2020; 19:3096-3099. [PMID: 32176424 DOI: 10.1111/jocd.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND XP is a flat xanthoma that usually presents as bilateral, symmetrical, soft, yellowish papules over the eyelids. The etiology of XP is unknown, but it may be related to complex heterozygous mutations. AIMS To investigate the lipid profiles, important clinical characteristics, and low-density lipoprotein receptor (LDLR) gene mutation in the patients suffering from xanthelasma palpebrarum (XP) with nonfamilial hypercholesterolemia. PATIENTS/METHODS The prospective study included 25 individuals of XP with nonfamilial hypercholesterolemia, and 30 controls neither with XP nor familial hypercholesterolemia (FH). Each one underwent detailed clinical examination, serum lipid profile, and LDLR gene detection at the 400th exon and the 1246th exon. RESULTS In our study, patients with XP were often not present with FH and family history. The mean serum cholesterol (CHOL) (5.20 ± 1.82) and the prevalence of carotid atherosclerosis (4.34 ± 0.78) were significantly higher in study group, while there was no statistically significant difference between two groups in terms of triglyceride (TG) (P = .38) and low-density lipoprotein (LDL) (P = .23). Unusually, the mean levels of high-density lipoprotein (HDL) (1.59 ± 0.31) in the study group were much higher than the controls (1.31 ± 0.30), and the LDLR gene mutation was not found. CONCLUSION Clinical and serum lipid profiles indicated that XP was sporadic and underlying lipid abnormalities especially higher HDL. XP did not occur with mutations in the LDLR gene at the two exons. We suggested too high HDL level may be contributed to pathogenesis of XP and XP is often not associated with FH.
Collapse
Affiliation(s)
- Wang Zhimin
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Wang Hui
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Ji Fengtao
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Sun Wenjuan
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| | - Li Yongrong
- Ophthalmology, The Second People's Hospital of Hefei, Hefei, Anhui, China
| |
Collapse
|
8
|
Wilkinson PE, Merkourea S, Gopalakrishnan R, Argyris PP. Primary Intraosseous Xanthomas of the Jaws: A Series of Six Cases Including an Example with Formation of Apoptosis-Related Hyaline Globules, So-Called "Thanatosomes". Head Neck Pathol 2020; 14:859-868. [PMID: 31916206 PMCID: PMC7669974 DOI: 10.1007/s12105-020-01126-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022]
Abstract
Primary intraosseous xanthomas of the jaws (PIXJ) are rare and predominantly affect the posterior mandible (86%) of normolipemic patients, with a mean age of 30 years and no gender predilection. Clinically, PIXJ exhibit indolent biologic behavior; curettage is considered treatment of choice. Only 36 PIXJ have been reported. Apoptosis-related hyaline globules (HGs), also known as "thanatosomes", have not been previously reported in PIXJ. Cases diagnosed as xanthoma of bone were retrieved. Six cases fulfilling currently accepted criteria were identified and their clinicopathologic and immunohistochemical properties are presented herein. Mean age for PIXJ was 21.8 years (range = 12-33) and F:M ratio = 2:1. All cases presented as well-demarcated, unilocular or multilocular radiolucencies. Microscopically, PIXJ featured sheets of lipid-laden macrophages with eosinophilic or foamy cytoplasm. A secondary fibroblastic population lacking storiform pattern was evident in two cases. Adipocytes (3/6), peripheral neurovascular bundles (1/6), bone fragments (3/6) and dystrophic calcifications (3/6) were observed enclosed by the xanthoma cells. Notably, one case exhibited numerous, spherical, eosinophilic HGs containing apoptotic nuclei. PIXJ were consistently CD68(+) and negative for CD1α and S100. CD45 decorated lymphocytes and the membrane of foamy histiocytes. Xanthoma cells stained for lysozyme and plasma proteins including alpha-1 antitrypsin (AAT), IgG and IgA in one probed case. HGs were lysozyme(+), AAT(+), IgG(+), IgA(+), PAS(+) and diastase-resistant, and fuchsinophilic with Masson's trichrome. PIXJ represent infrequent, solitary, mandibular lesions with a predilection for the second and third decade of life. Thanatosomes associated with cell injury and death can be present in PIXJ.
Collapse
Affiliation(s)
- Peter E. Wilkinson
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA
| | - Stavroula Merkourea
- grid.5216.00000 0001 2155 0800School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Rajaram Gopalakrishnan
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA
| | - Prokopios P. Argyris
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Department of Biochemistry, Molecular Biology, and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455 USA
| |
Collapse
|
9
|
Subbotina MV, Kanya OV. [Bilateral temporal bone xanthoma associated with hyperlipidemia]. Vestn Otorinolaringol 2020; 85:49-52. [PMID: 32476390 DOI: 10.17116/otorino20208502149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Presented clinical observation of a 42-year-old patient with bilateral xanthoma of the temporal bone, who has been treated for a long time for bilateral external otitis media, repeatedly mastoiditis. In this case, hyperlipidemia was detected only after the diagnosis of xanthoma was established. In this case, histological and clinical data helped to diagnose xanthomas and exclude chronic otitis media: the preservation of the auditory ossicles and hearing despite a large destruction of the temporal bone; satisfactory condition of the patient for many years in the presence of volumetric formations in both temporal areas extending into the cranial cavity, spreaded from the brain substance and not accumulating contrast according to computer and magnetic resonance imaging; normalization of hearing against the background of prolonged heating of the body - 'melting' of fats and opening the ear canal. Fistulas, through which a yellowish secret stood out either in the external auditory canal or in the behind-the-ear area, served as a kind of 'whisper valve', which made it possible to stop the pain syndrome and did not lead to the development of cerebral symptoms.
Collapse
Affiliation(s)
- M V Subbotina
- Irkutsk State Medical University, Department of Otorhinolaryngology, Irkutsk, Russia
| | - O V Kanya
- Irkutsk Regional Pathologicanatomical Bureau, Irkutsk, Russia
| |
Collapse
|
10
|
de Arruda JAA, Almeida TFA, Abreu LG, do Amaral MBF, Anbinder AL, Flores RM, Agostini M, Romañach MJ, Silva TA, de Andrade BAB, Mesquita RA. Intraosseous xanthoma of the mandible: A multi‐institutional case series with a literature review. J Oral Pathol Med 2019; 48:935-942. [DOI: 10.1111/jop.12940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022]
Affiliation(s)
- José Alcides Almeida de Arruda
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | - Lucas Guimarães Abreu
- Department of Paediatric Dentistry, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | - Ana Lia Anbinder
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology Universidade Estadual Paulista ‐ UNESP São José dos Campos Brazil
| | - René Martínez Flores
- Department of Oral Medicine and Oral Pathology, School of Dentistry Universidad Andrés Bello Viña del Mar Chile
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil
| |
Collapse
|
11
|
99mTc-HDP SPECT/MRI in isolated xanthoma of the temporal bone. Rev Esp Med Nucl Imagen Mol 2015. [DOI: 10.1016/j.remnie.2015.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
12
|
Morel D, Kelsch RD, Nolan PJ. Primary Xanthoma of the Mandible: Report of a Rare Case. Head Neck Pathol 2015; 10:245-51. [PMID: 26254177 PMCID: PMC4838967 DOI: 10.1007/s12105-015-0643-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/30/2015] [Indexed: 11/29/2022]
Abstract
Xanthoma is a lesion most commonly seen in soft tissues such as the skin, subcutis, or tendon sheaths. Xanthoma formation is often associated with primary or secondary hyperlipidemia. Primary bone xanthomas are extremely rare benign bone lesions not associated with hyperlipidemia, histopathologically characterized by histiocytes, abundant lipid containing macrophages (foam cells), and multinucleated giant cells. Cholesterol clefts can be found in the medullary bone. Less than ten cases of xanthoma in the mandible have been reported. We present a rare primary intrabony xanthoma in a normolipidemic patient.
Collapse
Affiliation(s)
- Dominic Morel
- />Division of Oral and Maxillofacial Surgery, Department of Dentistry, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY 10467-2490 USA
| | - Robert D. Kelsch
- />Departments of Dental Medicine and Pathology and Laboratory Medicine, NSLIJ Health System, New Hyde Park, NY USA , />Departments of Dentistry and Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY USA
| | - Patrick J. Nolan
- />Division of Oral and Maxillofacial Surgery, Department of Dentistry, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY 10467-2490 USA , />Albert Einstein College of Medicine, Bronx, NY USA
| |
Collapse
|
13
|
Lojo-Ramírez JA, García-Gómez FJ, Kaen A, Roldán F, Marcilla-Plaza D, Acevedo-Báñez I. (99m)Tc-HDP SPECT/MRI in isolated xanthoma of the temporal bone. Rev Esp Med Nucl Imagen Mol 2015. [PMID: 26198794 DOI: 10.1016/j.remn.2015.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J A Lojo-Ramírez
- Department of Nuclear Medicine, Universitary Hospital Virgen del Rocío, Seville, Spain.
| | - F J García-Gómez
- Department of Nuclear Medicine, Universitary Hospital Virgen del Rocío, Seville, Spain
| | - A Kaen
- Department of Neurosurgery, Universitary Hospital Virgen del Rocío, Seville, Spain
| | - F Roldán
- Department of Radiology, Universitary Hospital Virgen del Rocío, Seville, Spain
| | - D Marcilla-Plaza
- Department of Pathology, Universitary Hospital Virgen del Rocío, Seville, Spain
| | - I Acevedo-Báñez
- Department of Nuclear Medicine, Universitary Hospital Virgen del Rocío, Seville, Spain
| |
Collapse
|
14
|
Han Y, Gao W, Liang P, Wang S, Chen Y, Qiu J. Clinical features of bilateral temporal bone xanthoma with LDLR gene mutation. Int J Pediatr Otorhinolaryngol 2015; 79:1148-51. [PMID: 25921077 DOI: 10.1016/j.ijporl.2015.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 04/09/2015] [Accepted: 04/12/2015] [Indexed: 11/26/2022]
Abstract
Here we presented a rare case of bilateral temporal bone xanthoma associated with type II hyperlipidemia. The lesion caused osteolytic destruction in mastoid air cells, auditory ossicles and bony labyrinth. The patient was operated on the symptomatic side and the lesion was totally removed. The type of LDLR gene mutation had been clarified for the members of the patient's family. This case was the first one regarding bilateral temporal bone leading to retroauricular swelling. The patient need life-long follow-up by either CT or MR imaging.
Collapse
Affiliation(s)
- Yu Han
- Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Wei Gao
- Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Pengfei Liang
- Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Shujuan Wang
- Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Yang Chen
- Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
| | - Jianhua Qiu
- Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| |
Collapse
|
15
|
González-García L, Asenjo-García B, Bautista-Ojeda MD, Domínguez-Páez M, Romero-Moreno L, Martín-Gallego Á, Arráez-Sánchez MÁ. Endoscopic endonasal resection of clival xanthoma: case report and literature review. Neurosurg Rev 2015; 38:765-9. [PMID: 25820465 DOI: 10.1007/s10143-015-0630-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 02/01/2015] [Indexed: 10/23/2022]
Abstract
Bone xanthoma is an extremely rare and benign tumor in terms of its nature and growth over time. We describe the first case coexisting with ventriculomegaly secondary to aqueduct stenosis (non-tumoral hydrocephalus), the second xanthoma of the clivus described to date. The patient was a 51-year-old woman with headaches and absence seizures. Axial T1-weighted MRI showed a well-demarcated, hypointense, osteolytic, 25 × 18 × 15 mm lesion with cortical erosion located at the right margin of the clivus. Sagittal T2-weighted MRI demonstrated a hypointense mass without associated edema. Sagittal gadolinium-enhanced T1-weighted MRI showed contrast uptake with a partially hypointense rim. The increased ventricular size without periventricular edema was associated with aqueduct stenosis, and there was no contiguity with the tumor. A neuronavigation image-guided transsphenoidal approach was chosen to perform a macroscopically complete resection. Intraoperative histopathological study showed a chordoma of the clivus. Exhaustive postsurgical study revealed the benign nature of a bone xanthoma. Given the finding of a clival lesion, the differential diagnosis is essentially with other malignant entities with a rapidly fatal outcome, such as metastases, or with a possible invasive evolution, such as clivus chordomas. This report describes the clinical, radiological, and pathological keys for such differentiation in order to avoid unnecessarily aggressive treatment with ablative surgery and radiotherapy.
Collapse
|
16
|
Broadway SJ, Arnautovic KI, Zhang Y. Xanthoma of the occipital bone and with preserved inner and outer bone cortex: case report. J Neurol Surg Rep 2013; 74:29-32. [PMID: 23943717 PMCID: PMC3713555 DOI: 10.1055/s-0033-1346973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 02/25/2013] [Indexed: 11/08/2022] Open
Abstract
Objective We present a unique case of a midline xanthoma of the occipital bone exhibiting atypical imaging characteristics with preserved bone cortex that has not previously been described. Participant This man presented with refractory headaches and suboccipital pain and a mass within the diploe of the occipital bone but with preserved inner and outer cortex of the bone. Magnetic resonance imaging showed a midline, enhancing, and marrow-replacing process in the occipital bone measuring 1.5 cm in anteroposterior (AP) diameter, resulting in mild indentation of the dorsal aspect of the cerebellar vermis. Results The patient underwent a suboccipital craniectomy. Tumor resection was from the foramen magnum to the inion and laterally until normal bone was encountered. The xanthoma was yellowish and bled a moderate amount upon resection. Conclusion An isolated cranial xanthoma with preserved inner and outer bone cortex involving the occipital bone and of midline location has yet to be described. The differential diagnosis of osteoexpansile skull lesion with preserved bone cortex should now include xanthoma. Given the broad spectrum of imaging characteristics exhibited by this unusual diagnosis, surgical intervention is indicated from a diagnostic as well as a therapeutic standpoint.
Collapse
Affiliation(s)
- S Jared Broadway
- Semmes-Murphey Clinic and Department of Neurosurgery, Health Science Center, University of Tennessee, Tennessee, USA
| | | | | |
Collapse
|
17
|
A rare case of primary bone xanthoma of the clivus. Brain Tumor Pathol 2012; 29:123-8. [PMID: 22215107 DOI: 10.1007/s10014-011-0073-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
Primary bone xanthoma is a rare type of tumor, and those developing primarily within the skull are even more unusual. In this case, a primary bone xanthoma of the clivus without endocrine or metabolic complications represents the first of this type to be reported. The patient, a 24-year-old woman, initially experienced frequent headaches. Subsequent skull tomography and bone-window computed tomography (CT) revealed a clearly demarcated osteolytic lesion in the clivus. T1-weighted magnetic resonance imaging (MRI) exhibited low intensity, and T2-weighted MRI showed iso-high intensity and a heterogeneously faint contrast effect. The tumor was completely resected, after which the patient's headaches disappeared completely. Because xanthoma is devoid of neoplastic features, it does not necessarily require aggressive therapy. Therefore, it is very important to understand the characteristics of its clinical symptoms and to give due consideration to differential diagnosis based on pathological presentations and imaging features. This study introduces information regarding a bone xanthoma originating within the skull, together with a review of bone xanthoma literature.
Collapse
|
18
|
Abstract
Bone xanthoma is a rare disease due to the presence of cholesterol deposits in the bone. We report a case of a 56-year-old patient who was hospitalized in orthopedic department for fracture on the left humerus. Histological examination of bone biopsy performed at this site has objectified cholesterol deposits. Laboratory tests showed hypercholesterolemia with hypertriglyceridemia. The diagnosis of bone xanthoma was selected. The fracture was treated surgically. An initial bone scan revealed bone lesions localized especially at the humerus and femur. The patient was put under fenofibrate and statins. The evolution was marked by gradual regression of lesions in bone scans of control.
Collapse
|
19
|
Kalyan Chakravarthi V, Aruna E, Naveen Chandra Rao D, Ranga Rao D. Bilateral Tibial Xanthoma in a Normolipidemic Patient—Report of a Rare Case with Review of Literature. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ijcm.2012.33047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
20
|
de Moraes Ramos-Perez FM, de Pádua JM, Silva-Sousa YTC, de Almeida OP, da Cruz Perez DE. Primary xanthoma of the mandible. Dentomaxillofac Radiol 2011; 40:393-6. [PMID: 21831981 DOI: 10.1259/dmfr/51850495] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Bone xanthomas are rare and are usually are associated with endocrine or metabolic diseases, mainly lipid disorders. In the absence of systemic diseases, the lesion is called a primary xanthoma. Primary mandibular xanthomas are extremely rare. The aim of this report is to describe the clinical and radiographic findings of a primary mandibular xanthoma, discussing the epidemiological features, pathogenesis and differential diagnosis. A 25-year-old man was referred for evaluation of a left mandibular lesion detected in a routine radiographic exam. Radiographically, there was a diffuse, unilocular and radiolucent lesion, with irregular margins located adjacent to the surface from the distal root of the left mandibular third molar. The lesion was excised under local anaesthesia. Microscopically, there were several cells with a foamy and granular cytoplasm and central small, round nuclei, similar to xanthomatous macrophages. No lipid disorders were diagnosed. According to these features, the diagnosis of primary mandibular xanthoma was established. In conclusion, xanthomas of the jaws are rare and all seem to be primary and occur exclusively in the mandible.
Collapse
|