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.