Xanthogranuloma of Bone: A Challenging Imitator of Malignancy

Holmes, Brittany J.; Castelino-Prabhu, Shobha; Rosenthal, Dorothy L.; Ali, Syed Z.

doi:10.1159/000345900

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…Furthermore, all of the previously mentioned cases have been reported in long bones namely femur, humerus, ulna, ribs, phalynx and tibia. 1 2 3 4 5 6 7 8 9 Involvement of small bones in the form of talus and cuboid makes this case unique. Borjian et al .…”

Section: Discussionmentioning

confidence: 98%

Multifocal bilateral xanthogranulomatous osteomyelitis

Sapra

Jain

Gupta³

et al. 2015

IJOO

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Xanthogranulomatous osteomyelitis is a rare chronic inflammatory disorder which clinically resembles bone tumor. It is characterized histologically by the presence of a large number of foamy histiocytes admixed with lymphocytes and plasma cells. Xanthogranulomatous inflammation can involve any organ, with kidneys and gall bladder being the worst affected. Only anecdotal cases of osteomyelitis have been reported in the past with scant medical literature. However, all the earlier reported cases, except one, were unifocal lesions. The authors present a case of multifocal xanthogranulomatous osteomyelitis involving the left medial malleoli, left talus and the right cuboid bones.

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Section: Discussionmentioning

confidence: 98%

Multifocal bilateral xanthogranulomatous osteomyelitis

Sapra

Jain

Gupta³

et al. 2015

IJOO

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“…5 6 7 8 It has also been found in other sites like bones, testis, and small intestine. 5 9 10 The involvement of the female genital tract is somewhat less common, which can present as endometritis, oophoritis, and salpingitis. 4 11 12 The ovarian involvement sometimes has been referred to as ovarian fibroxanthoma.…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous Oophoritis in the Setting of Post-IVF Twin Pregnancy with History of Endometriosis: A Rare Case Report with Review of Literature

Pendharkar

B.S

Pendkur

et al. 2022

Indian J Med Paediatr Oncol

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Xanthogranulomatous inflammation is an uncommon, nonneoplastic, chronic process in which the affected organ is destroyed by massive cellular infiltration of foamy histiocytes admixed with multinucleated giant cells, plasma cells, fibroblasts, neutrophils, and foci of necrosis. The organs most commonly affected by this entity are kidney and gallbladder. Only a few cases involving the ovary have been reported. The etiology of this entity is unknown, but the associated risk factors are infection, inappropriate antibiotic therapy, use of intrauterine contraceptive device, abnormalities in lipid metabolism, endometriosis, leiomyoma, and recurrent pelvic inflammatory disease. The current case was a 31-year-old female with post-in vitro fertilization (post-IVF) twin pregnancy, who presented with pain in the abdomen, provisionally diagnosed as ovarian mass with suspicion of malignancy. Patient was treated with antibiotics and an elective lower segment cesarean section was planned, due to lower abdominal pain and the presentation of both fetuses being breech. Patient underwent exploratory laparotomy with right oophorectomy and left double-J stenting, in view of left hydronephrosis. Diagnosis of xanthogranulomatous oophoritis was established on histopathological examination. There is only a single case; previously documented from India, in the setting of primary infertility. The present case report stresses that the condition may affect women of any age group and may be encountered in pregnancy, as has been observed in this case. Hence, thinking about this differential diagnosis in the cases presenting with similar complaints, would be of great value to avoid misdiagnosing them.

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“…XO was first introduced in the reports of 2 cases in 1984 followed by reports of 18 other patients summarized in the Table. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] A review of these 20 cases and the case of our patient suggests that XO is more prevalent in males (15 of 21) than females and has no characteristic age distribution. Most patients (17 of 21) had unifocal XO; only 4 had multifocal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…As with our patient, pain and swelling of the involved bone seem to be the primary reason for presentation. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Cheema et al attributed the pathogenesis of xanthogranulomatous process in bone to a delayed-type hypersensitivity reaction of cell-mediated immunity. 22 Trauma has been also mentioned as a hypothetical reason for this process.…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous Osteomyelitis of the Tibia

Solooki

Hoveidaei

Kardeh

et al. 2019

TOJ

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Background: Xanthogranulomatous osteomyelitis (XO) is a rare chronic inflammatory process that is histologically characterized by the presence of foamy macrophages, histiocytes, and plasma cells. Radiologic and gross examinations can mimic malignancy, so definitive diagnosis should be made by histopathologic evaluation. Case Report: A 15-year-old male presented with pain in the proximal right leg for 2 weeks prior to admission. The patient had a history of leg trauma 3 years prior that was responsive to as-needed analgesics. Laboratory data revealed increased erythrocyte sedimentation rate and C-reactive protein. X-ray of the right tibia showed a periosteal reaction and bulging of bone with a questionable destruction of the cortex. Magnetic resonance imaging demonstrated an expansile bony lesion in the proximal metaphysis of the tibia. Histopathologic examination showed the bone trabecula surrounded by chronic inflammatory cells and a fragment of dead bone surrounded by histiocytes, foamy macrophages, and plasma cells. The pathologist confirmed the diagnosis of XO. Wound culture proved moderate growth of Staphylococcus aureus, and treatment with cefazolin and cephalexin was successful. Conclusion: The patient was not treated with the routine therapy used in previously reported cases (curettage), suggesting that antibiotic therapy should be considered before employing surgical interventions for XO.

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Xanthogranuloma of Bone: A Challenging Imitator of Malignancy

Cited by 6 publications

References 29 publications

Multifocal bilateral xanthogranulomatous osteomyelitis

Multifocal bilateral xanthogranulomatous osteomyelitis

Xanthogranulomatous Oophoritis in the Setting of Post-IVF Twin Pregnancy with History of Endometriosis: A Rare Case Report with Review of Literature

Xanthogranulomatous Osteomyelitis of the Tibia

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