Xanthoma is designation for a local subcutaneous deposit of cholesterol, which can occur anywhere in the body. Although the suffix –oma is in medical terminology usually used for tumors, the xanthoma does not have anything common with benign or malignant tumors.
The cause of xanthomas is high level of cholesterol that accumulates in the tissues. This level must be very high and therefore, xanthomas are typically found in congenital disorders of the cholesterol metabolism such as the familial hypercholesterolemia. Similarly, we also find xanthomas in patients who for some reason have chronically obstructed the bile ducts (for example by a tumor). The cholesterol is excreted via the bile into the intestine and when this path is blocked, it begins to accumulate in the tissues.
The xanthomas look like subcutaneous lumps of various size, they are often located on the legs near muscle tendons. The xanthomas have the skin-color or they are slightly discolored ranging from yellowish to pale orange. When palpated, they are rather soft.
Xanthoma can be with a relatively high accuracy recognized by the naked eye. Serum level of cholesterol should be checked and when it is high, the diagnosis is clear.
The principle of the therapy is treatment of the underlying cause. Usually, we use drugs lowering the cholesterol level. The xanthomas are harmless (except their cosmetic effect), but the patient is threatened by the accelerated process of atherosclerosis and its complications. Large xanthomas can be surgically removed, but when the high level of cholesterol is not solved, they tend to recur.
It is usually a cholesterol-lowering medication. Xanthoma itself is indeed harmless (except cosmetic point of view), high cholesterol, however, a patient threatens the acceleration of the process of atherosclerosis, with all its complications. Significantly harassing xanthomas can be removed surgically, without adequate cholesterol lowering, however, tend to re-form.