Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2015; 3(1): 77-80
Published online Jan 16, 2015. doi: 10.12998/wjcc.v3.i1.77
Giant xanthogranuloma of the pelvis with S1 origin: Complete removal with only posterior approach, technical note
Nicola Marotta, Alessandro Landi, Cristina Mancarella, Pierluigi Rocco, Andrea Pietrantonio, Gaspare Galati, Antonio Bolognese, Roberto Delfini
Nicola Marotta, Alessandro Landi, Cristina Mancarella, Pierluigi Rocco, Andrea Pietrantonio, Roberto Delfini, Depa-rtment of Neurology and Psychiatry, Division of Neurosurgery, Policlinico Umberto I, “La Sapienza” Università di Roma, 00161 Rome, Italy
Gaspare Galati, Antonio Bolognese, Department of General Surgery “Pietro Valdoni”, Policlinico Umberto I, “La Sapienza” Università di Roma, 00161 Rome, Italy
Author contributions: All authors contributed to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alessandro Landi, MD, PhD, Department of Neurology and Psychiatry, Division of Neurosurgery, Policlinico Umberto I, “La Sapienza” Università di Roma, Viale del policlinico 155, 00161 Rome, Italy. dott.alessandro.landi@gmail.com
Telephone: +39-06-49979113 Fax: +39-06-49979113
Received: June 30, 2014
Peer-review started: July 1, 2014
First decision: August 14, 2014
Revised: October 14, 2014
Accepted: October 23, 2014
Article in press: December 23, 2014
Published online: January 16, 2015
Processing time: 197 Days and 17.9 Hours
Abstract

Xanthogranulomas (XG) are benign proliferative disorder of histiocytes, a non-Langerhans cell histiocytosis. Whose etiology is unknown. The nature of these lesions is controversial and could be either reactive or neoplastic; the presence of monoclonal cells does, however, favor the second hypothesis. Xanthogranuloma is frequently found in young adults and children (under 20 years old), mainly in the skin. In about 5%-10% of all Juvenile XG (JXG) cases xanthogranuloma are extracutaneous. Within this group, the site most frequently involved is the eye. Other involved organs are heart, liver, adrenals, oropharynx, lung, spleen, central nervous system and subcutaneous tissue, although involvement of the spine is uncommon. Isolated lesions involving the sacral region are extremely rare. To date, this is the first reported case of a giant JXG arising from S1 with extension into the pelvic region in an adult spine.

Keywords: Xanthogranulomas; Non-Langerhans cell histiocytosis; Touton giant cells; Congenital xanthoma; Neurofibromatosis

Core tip: Xanthogranulomas (XG) are benign lesions derived by histiocytes, also called histiocytosis with non-Langerhans cell. Isolated xanthogranuloma involving the sacral region are unique. We report the unique giant Juvenile XG arising from S1 with extension into the pelvic region in an adult spine. Complete surgical removal is the goal of the treatment and usually curative even if there is not a study in the literature with a long follow up able to confirm this. If total resection is not possible, the patients must be followed by strictly clinical examination or should undergo adjuvant radiotherapy.