The Rare Case of an Adult-Onset Xanthogranuloma of the Paranasal Sinuses: A Histological Dilemma

Abstract

Xanthogranuloma is a rare benign tumour, part of the non-Langerhans cell histiocytosis group, uncommon in adults and even less common in the paranasal sinuses. Despite its benign nature, it mimics neoplasm due to its local effects which can have serious functional consequences depending on the anatomical location. We present the rare case of a young lady who presented insidiously with a maxillary sinus xanthogranuloma and was treated with endoscopic resection. Tissue diagnosis is of paramount importance to guide correct further investigations and management, and we discuss the potential challenge in identifying such a rarely seen pathology.

Xanthogranuloma of nose in an adult: an uncommon presentation

“…4 Bastianpillai and colleagues reported a case of AXG of the right middle turbinate and uncinate process, which clinically mimicked as malignancy. 7 The patient presented with nasal obstruction and bloody discharge.…”

“…Piecemeal tumor excision was performed and the histopathological examination established the diagnosis. 7 AXG of nose may pose diagnostic challenge to both surgeons and pathologists and other common lymphohistiocytic lesions of nose needs to be excluded. The differential diagnoses include rhinoscleroma, lepromatous leprosy, verruciform xanthoma and necrobiotic xanthogranuloma.…”

Rare case of adult Xanthogranuloma: a case report

“…Treatment options for solitary lesions include surgical excision, retinoids and carbon dioxide laser. It is a benign condition with a good prognosis and is not typically invasive 3 .…”

“…Histiocytosis is categorised into three groups as Langerhans cell histiocytosis (LCH), non-Langerhans cell histiocytosis, and malignant histiocytosis. Within these groups are multiple disease subtypes, and xanthogranuloma falls within the non-LCH group 3 .…”