Primary intraosseous xanthoma of the frontal bone in a child: illustrative case.

Autor:	Madsen PJ; 1Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Kundishora AJ; 1Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Reeves BC; 2Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut., Coyle AM; 1Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Nagasawa DT; 3Department of Neurosurgery, Achieve Brain and Surgery Center, Santa Monica, California., Wong JM; 4Department of Neurosurgery, Memorial Health Care, Long Beach, California; and., Yang I; 5Department of Neurosurgery, University of California Los Angeles, Los Angeles, California., Tucker AM; 1Department of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2024 May 13; Vol. 7 (20). Date of Electronic Publication: 2024 May 13 (Print Publication: 2024).
DOI:	10.3171/CASE23640
Abstrakt:	Background: Skull lesions are a common finding in children, with dermoid cysts and eosinophilic granulomas observed most frequently. However, primary intraosseous xanthomas of the calvaria, which are lytic, expansile lesions that develop without underlying hyperlipidemic disease, are rare in children, with only one prior case reported. Observations: The authors describe the case of a healthy 6-year-old male who presented with a 2-month history of an enlarging midline skull mass that developed after a recent minor trauma. Imaging showed a full-thickness, lytic frontal bone lesion with an aggressive appearance and heterogeneous contrast enhancement. The patient underwent gross-total resection of the lesion with placement of a mesh cranioplasty. Histopathology revealed a primary intraosseous xanthoma. The patient was discharged on postoperative day 2 and required no further treatment at the 1-month follow-up. Lessons: This is the first reported case of a primary intraosseous xanthoma in the frontal bone of a pediatric patient. It emphasizes the need to include primary xanthomas in the differential diagnosis for pediatric skull lesions, particularly when the lesion has an aggressive radiographic appearance or the patient has a history of focal trauma. Furthermore, our findings indicate that resection, together with subsequent monitoring for lesion reccurrence, is an adequate first-line treatment.
Databáze:	MEDLINE
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