Hip Pelvis.  2016 Sep;28(3):182-186. 10.5371/hp.2016.28.3.182.

Primary Intraosseus Xanthoma Involving the Proximal Femur in a Normolipidemic Patient: A Case Report

• Shin WC
• Moon NH
• Suh KT

• KMID: 2354552
• DOI: http://doi.org/10.5371/hp.2016.28.3.182

Abstract

We report the case of a 25-year-old woman presenting with left hip pain. A lesion was found in the proximal femoral metaphysis. Benign bone tumor, such as intraosseous lipoma or liposclerosing myxofibrous tumor, was suspected based on simple radiographs and magnetic resonance images. Curettage of the lesion and bone grafting was performed. Histologic findings reflected primary intraosseous xanthoma of the proximal femur. Laboratory tests revealed the patient to be normolipidemic, while immunoelectrophoretic fractionation of lipoproteins revealed normal values for alpha, pre-beta, beta, and chylomicrons. At the one-year follow-up, there was no evidence of local recurrence. This is the first reported case of primary intraosseous xanthoma of the proximal femur in a normolipidemic patient.

Keyword

Primary intraosseous xanthoma; Normolipidemic; Proximal femur

MeSH Terms

Adult
Bone Transplantation
Chylomicrons
Curettage
Female
Femur*
Follow-Up Studies
Hip
Humans
Lipoma
Lipoproteins
Recurrence
Reference Values
Xanthomatosis*
Chylomicrons
Lipoproteins

Figure

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  Fig. 1 Preoperative radiograph, showing a large osteolytic lesion with well-defined margins in the proximal metaphysis of the femur, partially surrounded by sclerotic cortical bone.

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  Fig. 2 Magnetic resonance images, showing a well-demarcated intra-osseous lesion measuring 58×42×42 mm. (A) Fat-suppressed image. (B) Fast spin-echo T2-weighted image. (C) T1-weighted image. (D) Radionuclide bone scan.

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  Fig. 3 Postoperative radiograph, showing curettage and bone grafting with a femoral head allograft. Prophylactic internal fixation was performed to prevent fracture.

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  Fig. 4 Histopathologic results (hematoxylin and eosin stain, ×200). The lesion shows heavy infiltration of foamy histiocytes (arrows).

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  Fig. 5 One-year follow-up radiograph, showing removal of the implant and no progression of the osteolytic lesion.

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