Abstract
Primary intraosseous xanthoma (IOX) is a rare disease. The etiopathogenesis remains unclear and is considered independent of systemic diseases. A 19-year-old woman was referred to the oral pathology service after radiographic examination for orthodontic treatment. Physical examination showed no abnormalities. Panoramic radiography analysis demonstrated a multilocular, well-defined, noncorticated, irregular, radiolucent lesion at the posterior region of the right mandible. Multiplanar sections on computerized tomography demonstrated a hypodense image measuring 50 × 30 mm and no expansion of the bone cortical region. The clinical diagnosis was odontogenic cyst or tumor. Incisional biopsy proved inconclusive. Curettage was the choice of treatment. Histologic examination showed cells with a foamy and granular cytoplasm similar to foamy macrophages. Immunohistochemical staining of xanthomatous cells revealed strong positive result for CD68. Blood tests showed no abnormal results. A diagnosis of IOX was made. The patient was followed-up, and no recurrence was observed 3 years later. Support: FAPEMIG.
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