Case 44, part II: Xanthoma of the mandible

Mosby, Edward L.; Albright, Jimmy E.; Messer, Eugene J.; Nealis, Michael F.; Werning, John T.

doi:10.1016/0278-2391(83)90274-4

Cited by 16 publications

(30 citation statements)

References 5 publications

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“…The most commonly affected sites are the bones of the hand, although cases located in the long and pelvic bones, rib, cranium and vertebrae have been also reported. 2,4 In the jaws, xanthomas are extremely rare, 4 all seem to be primary and occur exclusively in the mandible, 1,6,7 as in the present case. The diagnosis of mandibular xanthomas becomes difficult mainly because of the absence of typical cutaneous manifestations and alterations in lipid values.…”

Section: Discussionsupporting

confidence: 56%

“…9 Particularly in primary bone lesions, the xanthomas can apparently occur in a pre-existing lesion, such as a simple bone cyst, aneurysmal bone cyst and fibrous dysplasia. 6 In the present case, the lesion was within a bone cavity, which could suggest the occurrence of a previous simple bone cyst, although it did not present on radiographic images as such. The lesion presented a close association with the distal root from the left mandibular third molar, but there was no continuity between the lesion and the oral cavity.…”

Section: Discussionmentioning

confidence: 44%

See 1 more Smart Citation

Primary xanthoma of the mandible

Ramos‐Perez¹,

Pádua²,

Silva-Sousa³

et al. 2011

Dentomaxillofacial Radiology

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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. Dentomaxillofacial Radiology (2011) 40, 393-396. doi: 10.1259/dmfr/51850495Keywords: jaws; mandible; xanthoma Case reportA 25-year-old man was referred to a private oral surgery clinic for an evaluation of a left mandibular lesion detected in a routine radiographic exam performed during orthodontic treatment. Medical history was not contributory and the patient denied pain or previous local trauma, including surgical procedures. At the extraoral examination, the face was symmetric, with a normal contour of the inferior portion of the face. On intraoral examination, the patient showed well conserved dentition and oral mucosa with a normal colour and texture without lesions or swelling. It was noted that the patient was undergoing orthodontic treatment owing to the presence of orthodontic brackets fixed to the crown of the teeth. Radiographically, there was a diffuse, unilocular and radiolucent lesion with irregular margins, located adjacent to the surface of the distal root of the left mandibular third molar, measuring approximately 2.0 cm (Figures 1 and 2). In this region, the upper and lower limits of the mandibular canal were not observed. The left mandibular third molar was intact and no percussion pain, facial paraesthesia or paralysis or periodontal pockets in the distal surface were observed.As the lesion presented diffuse and irregular margins, and no inflammatory signs and symptoms were observed, a primary or metastatic malignant neoplasm was considered as the main hypothesis of diagnosis. To establish the diagnosis, the patient was submitted to an incisional biopsy of the lesion under local anaesthesia. During the surgical procedure, it was observed that there was no continuity between the lesion and the oral cavity. Additionally, after accessing the local area surrounding the lesion, a bone cavity filled with a yellowish, soft and amorphous tissue was n...

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 44%

Primary xanthoma of the mandible

Ramos‐Perez¹,

Pádua²,

Silva-Sousa³

et al. 2011

Dentomaxillofacial Radiology

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“…In the mandible, reported xanthomas range from 1 to 4 cm [3,5,8,12], although the lesion in the present case was more significant and extended from the sigmoid notch to the mandibular midline. The radiographic appearance may range from a small, well-demarcated radiolucent lesion with sclerotic margins to diffuse appearance with small ill-defined radiolucencies and areas of increased density [3,4,12].…”

Section: Discussionmentioning

confidence: 66%

“…Most documented cases were seen between the third and fifth decades [3,5,8]. Male are affected twice as much as females [1,3].…”

Section: Discussionmentioning

confidence: 99%

Primary Xanthoma of the Mandible: Report of a Rare Case

Morel

Kelsch

Nolan

2015

Head and Neck Pathol

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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.

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“…4 Only three cases of xanthomas of bone involving the mandible have been described. [5][6][7] Mateo et al (2004) 5 reported an 11-year-old girl presenting with a poorly defined lesion, which caused asymmetry in the left mandible. A diffuse, unilocular, radiolucent lesion with irregular margins in the mandible was described in a 25-year-old man.…”

mentioning

confidence: 99%