Multiple Huge Tendinous Xanthomas with Normal Lipid Profiles in All Extremities

Abstract

Xanthomas are grayish-yellow masses composed of lipid-filled foamy histiocytes and are usually accompanied by familial hypercholesterolemia or some other disease associated with dysfunctional lipid metabolism. Here, we report a case of multiple huge tendinous xanthomas with normal lipid profiles involving all extremities. These masses were large enough to cause pain, dysfunction of extremities, and cosmetic compromise and the condition was accompanied by cerebrotendinous xanthomatosis. Due to the presence of many masses in all extremities, a two-stage operation was planned with a time gap of several months. At 1-month follow-up visits after first and second surgeries, although extension of the left middle finger was poor as a result of sacrificing the 3rd extensor digitorum communis tendon, no problems such as wound dehiscence, hematoma formation, or infection at operative sites were noted.