A rare case of primary bone xanthoma of the clivus

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.

Treatment of Familial Hypercholesterolemia with Intracranial Xanthoma: Case Report

“…It has been reported in the literature that intracranial xanthomas mostly occur in the temporal occipital region ( 4 ). The MR manifestations are mixed T1 and T2 signals, with flaky fat signal shadows, which are distinguished from diseases such as lipomas, cholesteatoma, and skull tumors ( 5 ).…”

Primary Bone Xanthoma: A Case Report

“…[12,13] Though its etiology remains unclear, [14] a mild trauma may be a causative factor. [14,15] These are characterized by the presence of cholesterol deposits in the bone which occurs as a result of the leakage of lipid from the blood vessels at the site of the lesion which is then taken up by the macrophages. [10,16,17] Some authors consider xanthomatous lesions as neoplastic under the broad categoryof benign fibrous histiocytomas, while others favor a ''primary'' xanthoma of bone as a separate reactive entity.…”

Unusual presentation of a simple bone cyst in the coronoid process of the mandible with xanthomatous cells

“…Some authors classify the xanthomas as: xanthomatous variant -when xanthomatous changes are found in preexisting bone lesions; secondary xanthoma -lesions associated with hyperlipidemia; and primary xanthoma -those not associated with hyperlipidemia 18,19 . Following the suggestion of these authors, the reported case could be considered a xanthomatous variant of simple bone cyst.…”