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On the knowledge of solitary juvenile xanthogranuloma of the eyelid: a case series and literature review. Graefes Arch Clin Exp Ophthalmol 2022; 260:2339-2345. [PMID: 35084531 PMCID: PMC9203400 DOI: 10.1007/s00417-022-05560-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/01/2022] [Accepted: 01/11/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Solitary eyelid juvenile xanthogranuloma (JXG) is extremely rare, and there is limited literature on its clinical features and treatment outcomes. Here, we present a case series and comprehensive review of the literature on patients with isolated eyelid JXG. METHODS We systematically extracted data from our institution's records of isolated eyelid JXG cases and conducted a search for additional cases from the literature utilising the PubMed, Wanfang, and Chinese National Knowledge Infrastructure (CNKI) databases. Patients with JXG were analysed with respect to age, sex, clinical presentation, therapy, and outcome. Group comparisons were performed. RESULTS Thirty-two patients (including 13 at our institution and 19 from prior publications) were identified. The median age at first presentation was higher in current patients than in the patients from the published cases (median 9 years, range 1.2 to 47.0 years; median 2 years, range 0.5 months to 46.0 years, respectively, P = 0.014). Of the patients who had known characteristics, no significant differences were observed between the two groups in terms of sex, affected eye, eyelid site, type of cutaneous involvement, or duration of symptoms (each P > 0.05). Seventeen (54.8%) patients were male. The most common lesion location was the upper eyelid (n = 10, 62.5%). Twenty-four (75.0%) cutaneous lesions had full-thickness skin involvement; 8 (25.0%) subcutaneous masses had a chalazion-like appearance. Histologically, the JXG masses were characterised by Touton giant cells with inflammatory cells. Additionally, there was no significant difference in treatment modalities between the two groups (P = 0.072), and 24 (75.0%) patients underwent surgical excision. The overall recurrence-free survival was 3.6 to 52.8 (median 27.0) months in the current patients. For published cases with available follow-up information, there was no recurrence in 10 cases and improvement in 1 case, with a median follow-up of 9.5 months. CONCLUSION Solitary eyelid JXG is a rare clinical entity and should be included in the differential diagnosis of eyelid mass lesions in patients of all age groups. Surgical excision is often selected for efficient treatment and to obtain an excisional biopsy.
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Gioco G, Rupe C, Basco A, Contaldo M, Gallenzi P, Lajolo C. Oral juvenile xanthogranuloma: An unusual presentation in an adult patient and a systematic analysis of published cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:42-49. [PMID: 34736900 DOI: 10.1016/j.oooo.2021.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The purpose of this study was to describe an unusual case of intraoral juvenile xanthogranuloma (JXG) and to perform a systematic review to investigate the available literature regarding oral JXGs. STUDY DESIGN We present a new case of oral JXG arising in a 36-year-old Italian woman and conducted a systematic literature review in PubMed, Web of Science, and Scopus, according to the PRISMA guidelines. RESULTS Our review of the English-language literature yielded 34 cases of oral JXG, which included our case report. CONCLUSIONS JXG is a non-Langerhans cell histiocytosis. Oral JXG has been reported, but it is a rare manifestation. Because of the rarity of oral lesions and possible variations in the clinical and histologic presentation, the correct diagnosis can be challenging, requiring a careful clinical and histopathologic evaluation with adjuvant immunohistochemical studies.
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Affiliation(s)
- Gioele Gioco
- Head and Neck Department, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cosimo Rupe
- Head and Neck Department, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Alessia Basco
- Head and Neck Department, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Contaldo
- University of Campania-Luigi Vanvitelli, Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Naples, Italy
| | - Patrizia Gallenzi
- Head and Neck Department, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma, Università Cattolica del Sacro Cuore, Rome, Italy
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Saifaldein AA, Almahmoudi FH, Babgi RI, Alsammahi AA. A Subcutaneous Juvenile Xanthogranuloma in a 4-Year-Old Girl Who Presented with a Lower Eyelid Mass. Case Rep Ophthalmol 2019; 10:153-159. [PMID: 31692617 PMCID: PMC6760366 DOI: 10.1159/000500224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/08/2019] [Indexed: 11/19/2022] Open
Abstract
Juvenile xanthogranuloma (JXG) is a relatively uncommon, benign, histiocytic proliferative cutaneous disorder that typically affects children, with the head and neck being the most common sites. The present case report describes an isolated subcutaneous JXG in a 4-year-old girl who presented with a circumscribed oval mass located in the lower eyelid of the right eye. This lesion was histologically diagnosed as JXG after a surgical resection of the mass.
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Affiliation(s)
- Amjad A Saifaldein
- Department of Ophthalmology, KAMC - Ministry of Health, Jeddah, Saudi Arabia
| | - Faeeqah H Almahmoudi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Rafaa I Babgi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
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Oza VS, Stringer T, Campbell C, Hinds B, Chamlin SL, Frieden IJ, Shah S. Congenital-type juvenile xanthogranuloma: A case series and literature review. Pediatr Dermatol 2018; 35:582-587. [PMID: 29999209 DOI: 10.1111/pde.13544] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND/OBJECTIVES Congenital juvenile xanthogranulomas are infrequently described in the medical literature. We report three previously unpublished cases and systematically review the literature to better characterize this variant. METHODS We surveyed English-language articles indexed in MEDLINE (1951-March 2017) and EMBASE (1974-March 2017) for cases of congenital-onset juvenile xanthogranulomas confirmed on histopathology. Cases were divided into two categories: cutaneous only or cutaneous with systemic involvement. RESULTS We identified 31 cases of congenital juvenile xanthogranulomas involving only the skin and 16 cases with systemic involvement. Congenital juvenile xanthogranulomas involving only the skin were large (> 3 cm), presented with various clinical morphologies, and showed signs of regression by 1 year of age. Atypical clinical presentations included exophytic tumors, infiltrative plaques, agminated plaques, and subcutaneous tumors. Complications included ulceration and anetodermic scarring. Infants with congenital cutaneous juvenile xanthogranulomas who also had systemic involvement typically had multiple cutaneous tumors and hepatic involvement and showed signs of spontaneous regression independent of treatment. CONCLUSIONS The medical literature supports that congenital juvenile xanthogranulomas behave in a fashion similar to that of juvenile xanthogranulomas of infancy or childhood. Congenital cutaneous juvenile xanthogranulomas with or without systemic involvement spontaneously regress. The varied clinical presentations in the skin may lead to misdiagnosis, inappropriate examination, and unnecessary treatments. Infants with multiple congenital cutaneous juvenile xanthogranulomas should be evaluated for systemic involvement, with a particular focus on the liver, because 72.2% of these children were found to have hepatic juvenile xanthogranulomas.
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Affiliation(s)
- Vikash S Oza
- Ronald O. Perelman Department of Dermatology, New York University, New York, NY, USA
| | - Thomas Stringer
- Department of Dermatology, University of California, San Francisco, CA, USA
| | | | - Brian Hinds
- Department of Dermatology, University of California, San Diego, CA, USA
| | - Sarah L Chamlin
- Division of Pediatric Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ilona J Frieden
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Sonal Shah
- Department of Dermatology, University of California, San Francisco, CA, USA
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Ladha MA, Haber RM. Giant Juvenile Xanthogranuloma: Case Report, Literature Review, and Algorithm for Classification. J Cutan Med Surg 2018; 22:488-494. [DOI: 10.1177/1203475418777734] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Juvenile xanthogranuloma (JXG) is a member of the non-Langerhans cell group of proliferative disorders of mononuclear phagocytes. JXG is a benign tumour of histiocytic cells. Classic JXG is divided into 2 main clinical subtypes: dome-shaped papules (<0.5 cm) and single/multiple nodules (<2.0 cm). A rare variant is referred to as giant; this term encompasses JXG lesions larger than 2.0 cm. In this article, we report a case of a congenital cutaneous giant JXG. In addition, we reviewed and analyzed all cases (n = 51) of giant JXG reported in the English literature. We propose an algorithm for classifying giant JXG based on the following factors: onset of lesions (congenital and acquired), number of lesions (solitary ± satellites and multiple), morphology of cutaneous/mucosal lesions (plaque, nodular, ulcerated-nodular, macular, and other), and extracutaneous manifestations.
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Affiliation(s)
- Malika A. Ladha
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Richard M. Haber
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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Ginat DT, Vargas SO, Silvera VM, Volk MS, Degar BA, Robson CD. Imaging Features of Juvenile Xanthogranuloma of the Pediatric Head and Neck. AJNR Am J Neuroradiol 2016; 37:910-6. [PMID: 26744443 DOI: 10.3174/ajnr.a4644] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 11/10/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Juvenile xanthogranuloma is a non-Langerhans cell histiocytosis primarily affecting children. The purpose of this study was to characterize the imaging features of histologically confirmed pediatric head and neck juvenile xanthogranuloma. MATERIALS AND METHODS A retrospective review was performed of medical records and imaging of histologically confirmed head and neck juvenile xanthogranuloma. RESULTS Ten patients (6 girls, 4 boys) 1 month to 12 years of age were imaged with ultrasound only (n = 1), CT only (n = 2), CT and ultrasound (n = 1), MR imaging only (n = 3), or MR imaging and CT (n = 3). Masses were solitary in 9 patients and multiple in 1. Solitary masses were located in the external auditory canal, infra-auricular region, infratemporal fossa with intracranial extension, frontal scalp, and subperiosteal space eroding the calvaria and along the dura. One patient with disseminated disease had scalp-, calvarial-, and dural-based masses. Clinical presentation included a mass or alteration in function. On sonography, juvenile xanthogranuloma appeared hypoechoic. On contrast-enhanced CT, masses appeared homogeneous and isoattenuating with muscle and sometimes eroded bone. On MR imaging, compared with the cerebral cortex, the masses appeared hyper- or isointense on T1 and hypo- or isointense on T2, had decreased diffusivity, and enhanced homogeneously. Juvenile xanthogranuloma was not included in the differential diagnosis in any case. CONCLUSIONS Head and neck juvenile xanthogranuloma has varied manifestations. Mild hyperintensity on T1, hypointensity on T2 compared with the cerebral cortex, decreased diffusivity, and homogeneous enhancement are characteristic. Awareness of these features should prompt radiologists to include juvenile xanthogranuloma in the differential diagnosis of pediatric head and neck masses.
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Affiliation(s)
- D T Ginat
- From the Departments of Radiology (D.T.G., V.M.S., C.D.R.)
| | - S O Vargas
- Pathology (S.O.V.) Harvard Medical School (S.O.V., V.M.S., M.S.V., B.A.D., C.D.R.), Boston, Massachusetts
| | - V M Silvera
- From the Departments of Radiology (D.T.G., V.M.S., C.D.R.) Harvard Medical School (S.O.V., V.M.S., M.S.V., B.A.D., C.D.R.), Boston, Massachusetts
| | - M S Volk
- Otolaryngology (M.S.V.) Harvard Medical School (S.O.V., V.M.S., M.S.V., B.A.D., C.D.R.), Boston, Massachusetts
| | - B A Degar
- Pediatric Oncology (B.A.D.), Boston Children's Hospital, Boston, Massachusetts Department of Pediatric Oncology (B.A.D.), Dana-Farber Cancer Institute, Boston, Massachusetts Harvard Medical School (S.O.V., V.M.S., M.S.V., B.A.D., C.D.R.), Boston, Massachusetts
| | - C D Robson
- From the Departments of Radiology (D.T.G., V.M.S., C.D.R.) Harvard Medical School (S.O.V., V.M.S., M.S.V., B.A.D., C.D.R.), Boston, Massachusetts.
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Moon HR, Won CH, Chang SE, Lee MW, Choi JH, Moon KC. Superficial and deep infiltrating congenital juvenile xanthogranuloma involving multiple skeletal muscles and associated with ulceration and generalized postinvolution atrophy. Pediatr Dermatol 2015; 32:431-2. [PMID: 25996675 DOI: 10.1111/pde.12392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We present a 2-day-old boy with a deep-seated giant juvenile xanthogranuloma infiltrating the skeletal muscles on his right lower limb. Unlike typical juvenile xanthogranuloma, the lesion has shown only partial spontaneous regression with large atrophic scar. However, despite the involvement multiple muscle on the right thigh, the patient has no evidence of orthopaedic sequelae.
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Affiliation(s)
- Hye-Rim Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Chan Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Cypel TKS, Zuker RM. Juvenile xanthogranuloma: case report and review of the literature. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2011; 16:175-7. [PMID: 19721800 DOI: 10.1177/229255030801600309] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present case report describes a juvenile xanthogranuloma in a five-month-old girl. A circumscribed papule was located below the right nasal ala and above the right vermilion border. The lesion was histologically diagnosed as a juvenile xanthogranuloma after surgical resection of the mass. Juvenile xanthogranuloma is an uncommon diagnosis, with the head, neck and trunk being the most common sites.
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9
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Unilateral swelling of the cheek. J Oral Maxillofac Surg 2008; 66:342-8. [PMID: 18201620 DOI: 10.1016/j.joms.2007.04.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 04/03/2007] [Indexed: 11/22/2022]
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San miguel fraile P, Quintana de la rosa J, Antón badiola I, Ortiz rey J. Xantogranuloma juvenil de pene. Actas Urol Esp 2008; 32:659-61. [DOI: 10.1016/s0210-4806(08)73906-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Numajiri T, Nishino K, Fujiwara T, Takeda K, Sowa Y. Juvenile xanthogranuloma presenting rapid progression after curettage: a case report with clinicopathological findings. J Plast Reconstr Aesthet Surg 2007; 60:1248-51. [PMID: 17950188 DOI: 10.1016/j.bjps.2006.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2006] [Revised: 06/07/2006] [Accepted: 06/11/2006] [Indexed: 11/17/2022]
Abstract
Juvenile xanthogranuloma is a relatively uncommon benign cutaneous fibrohistiocytic lesion that shows spontaneous regression. We report a case of juvenile xanthogranuloma, which formed a relatively large nodule and rapidly progressed after curettage. A 9-month-old girl had a mass in the skin over the lumbar region of her back that extended to the fascia. The lesion was histologically diagnosed as juvenile xanthogranuloma after total resection of the mass. Although preoperative diagnosis is quite difficult, plastic surgeons should be familiar with this entity. Juvenile xanthogranuloma should be considered in the differential diagnosis of benign tumours and tumour-like lesions in infants. The clinical presentation and histological findings are discussed.
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Affiliation(s)
- Toshiaki Numajiri
- Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
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Snijders D, Stenghele C, Monciotti C, Piccolo RL, Alaggio R, Zanon GF, Barbato A. Case for diagnosis: 4-month-old infant with increasing cough, hemoptysis, and anemia. Pediatr Pulmonol 2007; 42:844-6. [PMID: 17647288 DOI: 10.1002/ppul.20600] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 4-month-old caucasian infant presented non-productive cough, fever associated with hemoptysis, and increasing anemia. He had mild tachypnoea; routine lab tests were normal. The thoracic HRCT scan showed a very large mass in the right lung adherent to the thorax wall, well defined and limiting the medium and upper lobe; the mass was well vascularized, and with central hypodensic areas. Fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) cytology were normal. The definitive histology of the mass showed the presence of inflammatory cells admixed with fibroblasts and rare Touton giant cells in the lesion suggestive of a juvenile xanthogranuloma (JXG) of the lung.
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Affiliation(s)
- D Snijders
- Department of Pediatrics, Medical Hospital, University of Padua, Padua, Italy
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Abstract
This case report describes a preterm baby with juvenile extracutaneous xanthogranuloma that rapidly expanded. The tumor was excised because of rapid enlargement and extension into the thoracic inlet. To our knowledge, this is the first case of a preterm baby with extracutaneous juvenile xanthogranuloma. The case illustrates the need for careful surveillance of this lesion because it cannot always be managed conservatively.
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Affiliation(s)
- Cornelia Hagmann
- Division of Paediatrics, Imperial College, Hammersmith Hospital, London, UK.
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