Primary Bone Xanthoma: A Case Report
Abstract
Xanthoma of bone is a rare disorder of bone which occurs due to cholesterol deposits in the bone. Clinically the patients usually present with pain or fracture of the affected bone. Radiologically it presents as a lytic lesion, often with cortical expansion or disruption. Xanthoma of bone is usually associated with hyperlipidemia but rare cases of non- hyperlipidemia xanthoma are also reported, termed as primary bone xanthoma. Here we present a rare case of a 46-year-old male who presented with pain and swelling in the right middle finger. X ray showed lytic lesion in the proximal phalanx of right middle finger. Laboratory tests showed normal lipid profile. Bone biopsy and histological examination is necessary for diagnosis and to differentiate it from Rosai–Dorfman disease, Langerhans cell histiocytosis and fibrous/post traumatic dysplasia, malignant fibrous histiocytoma, or metastatic renal cell carcinoma. A diagnosis of primary bone xanthoma was made based on histology and immunohistochemistry. The fracture was treated surgically. The case report emphasises the role of histology in diagnosis of this rare clinical entity.References
Ahmed G, Al Dosari M, El-Mahi M, Abolfotouh S. Primary xanthoma of calcaneus bone: Case report. Int J Surg Case 2014; 5: 699-702.
Wang Z, Wei Z, Huang L, Ke1Z, Luo C, et al. Primary nonhyperlipidemiaxanthoma of bone: a case report with review of theliterature.Int J ClinExp Med 2014; 7: 4503-4508.
Guerrouj H, Mouaden A, BenRais N. Xanthoma of Bone: A CaseReport. Case Rep Endocrinol 2012
Ali S, Fedenko A, Matcuk G, Patel D, Gottsegen C, et al. Bilateralprimary xanthoma of the humeri with pathologic fractures: A case report. World J Radiol 2013; 5: 345-348.
Yaligod V, Mahesh S, Rudrappa GH, Choudhary L. Xanthoma of ulna. Journal of Evolution of Medical and Dental Sciences 2013; 35: 6691-6695.
Chakravarthi V, Aruna E, Chandra Raao DN, Ranga Rao D. Bilateral Tibia Xanthoma in a Normolipidemic Patient-Report of a RareCase with Review of Literature. Int J Clin Med 2012;3: 234-237.
Alhaneedi, Ghalib & Salameh, Motasem & Abu Hejleh, Hasan Azzam. (2018). Xanthoma of Bone: A Mini Review-2471-2671-1000130. Surgical Oncology. 04.
Wilkinson, P.E., Merkourea, S., Gopalakrishnan, R. et al. 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 and Neck Pathol 2020; 14: 859–868.
Kumar K, Matos Y, Thirkannad S. Intraosseous xanthoma of thedistal radius a report. Hand Surg 2014;19: 223-226.
Wang Z, Lin ZW, Huang LL, Ke ZF, Luo CJ, Xie WL, Wang LT. Primary non-hyperlipidemia xanthoma of bone: a case report with review of the literature. Int J Clin Exp Med 2014; 7(11): 4503-8.
DeMoraes RF, de Padua JM, Silva-Sousa YT, de Almeida OP, Da CPD. Primary xanthoma ofthe mandible. DentomaxillofacRadiol 2011;40: 393-396.
Boisgard S, Bringer O, Aufauvre B et al., Xanthomeosseuxsansdésordrelipidique: À propos d’un cas et revue de lalittérature. Revue du Rhumatisme 2000; 1:83–86.
Ayadi-Kaddour, Mlika M, Marghli A, Kilani T, and Mezni FE, “Xanthoma of the rib without hyperlipoproteinemia,” Respiratory Medicine CME 2008; 1: 40–42.
Elwood ET, Shahwan TG, Dajani N, Murray JD. Isolated xanthoma of the frontal bone. J Cr-aniofacSurg 2005; 16: 391-394.
Asano K, Sato J, Matsuda N, Ohkuma H. A rarecase of primary bone xanthoma of the clivus. Brain Tumor Pathol 2012; 29: 123-128.
Yokoyama K, Shinohara N, and Wada K, Osseous xantho-matosis and a pathologic fracture in a patient with hyper-lipidemia. A case report. Clinical Orthopaedics and Related Research 1988; 236: 307–310.
Dallari D, Marinelli A, Pellacani A et al., Xanthoma of bone: first sign of hyperlipidemia type IIB: a case report. Clinical Orthopaedics and Related Research 2003; 410: 274–277.
Bertoni F, Unni KK, McLeod RA, Sim FH: Xanthoma of bone. Am J ClinPathol 1988; 90:377-384.
Macdonald D, Fornasier V, Holtby R. Benign fibrohistiocytoma (xanthomatous variant) of the acromion: a case report and review of the literature. Archives of pathology & laboratory medicine. 2002; 126:599-601.
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