Key Clinical Message
Xanthomas is a rare benign disorder. This lesion is often associated with endocrine and metabolic diseases (e.g. diabetes mellitus, hyperlipidemia, etc) and characterized by deposition of lipid-laden histiocytes. We report one rare case of multiple tuberous xanthomas on bilateral buttocks with hypercholesterolemia. The patient visited doctors for palpable masses on his bilateral buttocks without any pain. In this case, ultrasonic(the iU22 scanner (Philips Healthcare, Andover, MA) equipped with a 12-5 MHz linear-array transducer.) manifestation revealed hyperechoic masses located in the skin and subcutaneous tissues of bilateral buttocks, and blood flow signals were abundant within the masses, and low-velocity, low-obstruction artery and low-velocity venous blood flow spectrum were detected. The patient was subsequently operated for surgical removal. The masses were all excised under local anaesthesia. The diagnosis was finally confirmed by postoperative pathologic examination. In conclusion,ultrasonic characteristic manifestation of multiple tuberous xanthomas on bilateral buttocks with hypercholesterolemia can provide important information for the diagnosis of this rare case.
Key words: multiple tuberous xanthomas, hypercholesterolemia, bilateral buttocks, ultrasonography
IntroductionXanthoma is a rare yellow-to-skin-colored benign lesion in patients with endocrine and metabolic diseases. 1 Multiple tubercular xanthomas of buttocks is also a rare complication of familial hypercholesterolemia. 2-4 And multiple tubercular xanthomas on bilateral buttocks with hypercholesterolemia are even an extremely rare lesion. Xanthomas are palpable masses that are typically located within the skin or subcutaneous tissue and consist of cholesterol, triglycerides, phospholipids, and numerous lipid-laden foamy macrophages. 5 It has been reported in previous literatures that xanthomatosis mainly occurs in eyelid, elbow, tendon, bone, and other parts, and it is more common in young children and middle-aged women. 6,7We reported an extremely rare case of bilateral buttocks xanthomas in a 31-year-old man. His last follow-up 5 years after surgery showed no sign of recurrence in clinical and ultrasonography (US) examination. Generally, the value of ultrasound diagnosis lies in defining the scope, layer, and depth of the lesion. Thereby, ultrasonic findings have certain auxiliary value for selection of surgical resection method.