Bilateral xanthogranuloma of the breast: Radiologic findings and pathologic correlation

A xanthogranuloma (XG) is a rare benign histiocytic disorder that occurs mostly in infants and young children. Approximately 15% of XGs occur in adults and usually appear as solitary lesions in the head and the neck region. In most cases, an XG appears as a solitary yellow-red cutaneous nodule in the head and the neck region that regresses spontaneously over a course of months to years. An extracutaneous XG is uncommon, and it can occur with or without a cutaneous XG. An extracutaneous XG most commonly occurs in the eye, but findings at other sites such as the central nervous system, lungs, liver, spleen, kidneys, and bone have also been reported. The pathogenesis of XGs is unknown. Although physical and infectious factors have been considered, most investigators postulate that they are caused by a reactive response to an unknown stimulus. Xanthogranulomas can be divided into juvenile and adult forms. Distinctive from the juvenile form, the adult XG rarely undergoes a spontaneous regression, and concomitant extracutaneous examples are very uncommon. Patients with adult XGs are mostly in their late teens to late 30s, although approximately 5% of the patients are in their 60s to 70s. We report an exceptional case of an adult breast XG in a 60-year-old woman.