Central Xanthoma of the Jaw Bones: A Benign Tumor

Abstract

Extragnathic xanthomas are seen in the bones or as soft tissue masses. They are often associated with hyperlipidemia and are considered as reactive or metabolic lesions. Only 19 cases of xanthomas of the jaws have been reported so far in the English literature. A total of ten cases of central xanthoma of the jaw bones were identified from the Oral and Maxillofacial Pathology biopsy services of the University of Washington and the Tufts University School of Dental Medicine, between the years 2000-2016. The demographic and clinical information on these cases was tabulated logically on the basis of age, gender, location and presence or absence of symptoms, extragnathic lesions and serum hyperlipidemia. Radiographic and histopathological features were also examined. The findings in these cases were correlated with those available from the previously reported cases. Majority of cases are seen in the second and third decades of life. There is no gender predilection. Jaw lesions presented as solitary radiolucencies with a predilection for the posterior mandible. Unlike maxillary lesions, pain and expansion are inconsistent findings in mandibular lesions. Jaw lesions are not associated with extragnathic bone or soft tissue involvement or a hyperlipidemia. The central xanthoma of the jaws is a unique benign tumor. Histopathologically, many other jaw lesions contain variable numbers of foamy histiocytes. Therefore, a diagnosis of a central xanthoma of the jaws must be made after excluding all other such histiocyte containing lesions. This requires correlation of histopathological findings with clinical and radiographic features.

Intraosseous xanthoma of the mandible: A multi‐institutional case series with a literature review

“…Glycaemia levels were reported in five studies and lipidemia levels in 12, being within normal limits in all cases. Only one study demonstrated a case of IOX of the jaws with hyperlipidaemia.…”

“…After the elimination of 192 duplicates, the parameters for inclusion and exclusion were applied to 442 references. A total of 16 articles reporting 31 cases of IOX of the jaws were selected . The studies included in the present literature review were case reports or case series.…”

“…The studies included in the present literature review were case reports or case series. The articles were from the US, Canada, Brazil, Sweden, the Netherlands, Spain, the UK, Japan and Australia …”

“…Thus far, few cases of IOX of the jaws with enough clinicopathologic and radiographic details to confirm the diagnosis have been documented in the literature . Since case series of IOX of the jaws are infrequent in the literature, in order to provide consistent and well‐documented reports that may serve as a basis for a better understanding of the lesion, we describe here a series of five new cases of IOX of the mandible in a multi‐institutional study, with emphasis on clinicopathological, radiographic and immunohistochemical data of this condition as compared with reports detected in a literature review.…”

Intraosseous mandibular xanthomas – an interesting diagnostic dilemma?

“…Compression of neurological structures may result in symptoms – as found in cases of intracranial xanthomas – but the lesion is otherwise considered asymptomatic. There are three reported cases of a maxillary intraosseous xanthoma within the literature and several cases of mandibular involvement, none of which report recurrence (see Table ). No malignant transformation of intraosseous xanthomas has been reported.…”