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Xanthoma of the occipital bone and with preserved inner and outer bone cortex: case report.

Broadway SJ, Arnautovic KI, Zhang Y - J Neurol Surg Rep (2013)

Bottom Line: Magnetic resonance imaging showed a midline, enhancing, and marrow-replacing process in the occipital bone measuring 1.5 cm in anteroposterior (AP) diameter, resulting in mild indentation of the dorsal aspect of the cerebellar vermis.Tumor resection was from the foramen magnum to the inion and laterally until normal bone was encountered.Given the broad spectrum of imaging characteristics exhibited by this unusual diagnosis, surgical intervention is indicated from a diagnostic as well as a therapeutic standpoint.

View Article: PubMed Central - PubMed

Affiliation: Semmes-Murphey Clinic and Department of Neurosurgery, Health Science Center, University of Tennessee, Tennessee, USA.

ABSTRACT
Objective We present a unique case of a midline xanthoma of the occipital bone exhibiting atypical imaging characteristics with preserved bone cortex that has not previously been described. Participant This man presented with refractory headaches and suboccipital pain and a mass within the diploe of the occipital bone but with preserved inner and outer cortex of the bone. Magnetic resonance imaging showed a midline, enhancing, and marrow-replacing process in the occipital bone measuring 1.5 cm in anteroposterior (AP) diameter, resulting in mild indentation of the dorsal aspect of the cerebellar vermis. Results The patient underwent a suboccipital craniectomy. Tumor resection was from the foramen magnum to the inion and laterally until normal bone was encountered. The xanthoma was yellowish and bled a moderate amount upon resection. Conclusion An isolated cranial xanthoma with preserved inner and outer bone cortex involving the occipital bone and of midline location has yet to be described. The differential diagnosis of osteoexpansile skull lesion with preserved bone cortex should now include xanthoma. Given the broad spectrum of imaging characteristics exhibited by this unusual diagnosis, surgical intervention is indicated from a diagnostic as well as a therapeutic standpoint.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph. High-power view showing large histiocytes with foamy cytoplasm and uniform, centrally located nuclei. Delicate fibrous bands separate the cells into small nests. Original magnification 20 × . Hematoxylin and eosin stain.
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FI120019-5: Photomicrograph. High-power view showing large histiocytes with foamy cytoplasm and uniform, centrally located nuclei. Delicate fibrous bands separate the cells into small nests. Original magnification 20 × . Hematoxylin and eosin stain.

Mentions: Pathological examination demonstrated histiocytes embedded within a loose, paucicellular fibrous stroma on low power (Fig. 4). High-power examination revealed large tumor cells with foamy cytoplasm and uniform, centrally located nuclei, which were separated into small nests by delicate fibrous bands (Fig. 5). The patient experienced an uneventful postoperative course. It has been 24 months since surgery, and his headaches and suboccipital pain have resolved.


Xanthoma of the occipital bone and with preserved inner and outer bone cortex: case report.

Broadway SJ, Arnautovic KI, Zhang Y - J Neurol Surg Rep (2013)

Photomicrograph. High-power view showing large histiocytes with foamy cytoplasm and uniform, centrally located nuclei. Delicate fibrous bands separate the cells into small nests. Original magnification 20 × . Hematoxylin and eosin stain.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713555&req=5

FI120019-5: Photomicrograph. High-power view showing large histiocytes with foamy cytoplasm and uniform, centrally located nuclei. Delicate fibrous bands separate the cells into small nests. Original magnification 20 × . Hematoxylin and eosin stain.
Mentions: Pathological examination demonstrated histiocytes embedded within a loose, paucicellular fibrous stroma on low power (Fig. 4). High-power examination revealed large tumor cells with foamy cytoplasm and uniform, centrally located nuclei, which were separated into small nests by delicate fibrous bands (Fig. 5). The patient experienced an uneventful postoperative course. It has been 24 months since surgery, and his headaches and suboccipital pain have resolved.

Bottom Line: Magnetic resonance imaging showed a midline, enhancing, and marrow-replacing process in the occipital bone measuring 1.5 cm in anteroposterior (AP) diameter, resulting in mild indentation of the dorsal aspect of the cerebellar vermis.Tumor resection was from the foramen magnum to the inion and laterally until normal bone was encountered.Given the broad spectrum of imaging characteristics exhibited by this unusual diagnosis, surgical intervention is indicated from a diagnostic as well as a therapeutic standpoint.

View Article: PubMed Central - PubMed

Affiliation: Semmes-Murphey Clinic and Department of Neurosurgery, Health Science Center, University of Tennessee, Tennessee, USA.

ABSTRACT
Objective We present a unique case of a midline xanthoma of the occipital bone exhibiting atypical imaging characteristics with preserved bone cortex that has not previously been described. Participant This man presented with refractory headaches and suboccipital pain and a mass within the diploe of the occipital bone but with preserved inner and outer cortex of the bone. Magnetic resonance imaging showed a midline, enhancing, and marrow-replacing process in the occipital bone measuring 1.5 cm in anteroposterior (AP) diameter, resulting in mild indentation of the dorsal aspect of the cerebellar vermis. Results The patient underwent a suboccipital craniectomy. Tumor resection was from the foramen magnum to the inion and laterally until normal bone was encountered. The xanthoma was yellowish and bled a moderate amount upon resection. Conclusion An isolated cranial xanthoma with preserved inner and outer bone cortex involving the occipital bone and of midline location has yet to be described. The differential diagnosis of osteoexpansile skull lesion with preserved bone cortex should now include xanthoma. Given the broad spectrum of imaging characteristics exhibited by this unusual diagnosis, surgical intervention is indicated from a diagnostic as well as a therapeutic standpoint.

No MeSH data available.


Related in: MedlinePlus