title: Solitary juvenile xanthogranuloma in cervical spine: case report and review of the literature.
abstract: Solitary juvenile xanthogranuloma (JXG) in the spinal column is extremely rare. Here, we report and characterize the case of xanthogranuloma of the upper cervical spine. A 18-year-old male presented with neck pain for 3 months, along with progressive quadriparesis and sensory loss of 2 months duration with urinary retention. Motor examination revealed spastic quadriparesis with power of 2/5 in all the 4 limbs. Magnetic Resonance Imaging (MRI) spine with contrast showed a dorsally placed intradural extramedullary lesion at the level of C2-C4 vertebral body. The lesion, measuring 2.9x1.7x1.4 cm, was isointense on T1WI, hypointense on T2WI, and enhanced homogenously on contrast. He underwent an emergency C2-C4 laminectomy and complete excision of the lesion. At 3-month follow-up, he was asymptomatic except for mild neck pain. MRI scan of the cervical spine done at follow-up, revealed complete excision of tumor without any residual lesion. Histopathological examination of the mass revealed a polymorphous population of sheets of bloated pale foamy histiocytes (xanthoma cells), numerous admixed mature lymphocytes and several Touton giant cells. The cells were positive for CD68, a histiocytic marker, and negative for CD1a (excludes LCH) and S-100 (excludes RDD).
authors.affiliation: NIMHANS, Department of Neurosurgery, Bangalore, Karnataka, India.
authors.forename: Subhas
authors.initials: S
authors.lastname: Konar
authors.forename: Paritosh
authors.initials: P
authors.lastname: Pandey
authors.forename: T C
authors.initials: TC
authors.lastname: Yasha
mesh_terms: D000293:Adolescent; D018968:CD58 Antigens / Q000378:metabolism; D002574:Cervical Vertebrae / Q000473:pathology; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D007796:Laminectomy; D008214:Lymphocytes / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D019547:Neck Pain / Q000209:etiology; D019635:Neurosurgical Procedures / Q000379:methods*; D011782:Quadriplegia / Q000209:etiology; D009418:S100 Proteins / Q000378:metabolism; D012678:Sensation Disorders / Q000209:etiology; D013122:Spinal Diseases / Q000601:surgery*; D014972:Xanthogranuloma, Juvenile / Q000601:surgery*
chemical_list: D018968:CD58 Antigens; D009418:S100 Proteins