Xanthoma of the Bone Mimicking Malignant Bone Tumor with Secondary Aneurysmal-Cystic Change: A Case Report

Abstract Background Xanthomas are commonly found in the soft tissues of hyperlipidemic patients. Rarely, they may involve the skeletal system, with various radiographic appearances, mimicking bone malignancies. Case presentation: A 55-year-old woman presented with back pain and bilateral lower limb weakness for several months. After serial imaging studies, multifocal osteolytic lesions were identified in the pelvis and spine, with the largest measuring 94 mm in diameter. An abnormal lipid profile and typical cutaneous presentation aided in the final pathological diagnosis of bone xanthoma. Conclusions Xanthoma of the bone may be confused with aggressive bone lesions radiologically. Clinical, laboratory, and physical findings, in addition to pathological features, are required to make an accurate diagnosis.