Cutaneous xanthoma

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Macroscopic features of the mucosal nodules in a Shih Tzu with multiple xanthomas[1]

Xanthomas are nodular granulomatous inflammatory lesions ('foam-cell tumors') characterized by accumulation of lipoprotein-laden macrophages within the skin[2], eye or sella turcica of the brain (xanthogranuloma).

These are rare lesions associated with defects in lipid metabolism or metabolic disorders, such as hyperlipidemia, diabetes mellitus[3], hypothyroidism or hyperadrenocorticism.

They are mostly observed in the subcutaneous tissue of the head, ears and inguinal region, as well as visceral organs such as the pituitary[4], spleen, liver, adrenal glands, stomach, duodenum, and pancreas.

Xanthomas also can be found in other tissues, including skin, tendons, and knee and elbow joints.

Diagnosis usually requires histological examination of tissue samples, showing characteristic clusters of large, vacuolated, lipid-laden macrophages covered by a hyperplasic, hyperkeratotic, squamous epithelium[5].

A differential diagnosis would include balloon cell melanoma, granulomatous inflammation and xanthoma secondary to a metabolic defects[6].

If cutaneous xanthoma is involved, treatment is usually curative with excisional biopsy. Visceral xanthomas require more difficult extractions.


  1. Balme E et al (2009) Multiple atypical mucosal xanthomas in a dog similar to human verruciform xanthoma. J Vet Diagn Invest 21(1):124-128
  2. Gumbrell RC (1972) A case of multiple xanthomatosis and diabetes mellitus in a dog. N Z Vet J 20(12):240-242
  3. Chastain CB & Graham CL (1978) Xanthomatosis secondary to diabetes mellitus in a dog. J Am Vet Med Assoc 172(10):1209-1211
  4. Cramer SD et al (2011) Sellar xanthogranuloma in a dog. J Vet Diagn Invest 23(2):387-390
  5. Romanucci M et al (2008) Xanthogranulomatous inflammation of the small bowel in a dog. Vet Pathol 45(2):207-211
  6. Mays MB et al (1985) A xanthomatous lesion resembling balloon cell melanoma of the iris and ciliary body of a dog. J Comp Pathol 95:217–225