A Case of Juvenile Xanthogranuloma of the Hand in an Adolescent

Most soft tissue hand tumors are benign, but excision may be performed to confirm diagnosis, relieve pain, or improve function. This report describes a 16-year-old male patient with a growing, intermittently painful dorsal hand mass that was excised for diagnostic purposes and possible pain relief, which was subsequently identified as a juvenile xanthogranuloma. As a result of these pathological findings, our patient underwent specialist evaluation, and no further lesions or systemic involvement were identified. He was followed up postoperatively for 3 months without complications. Juvenile xanthogranulomas are rare and most often present in infants and young children as a solitary yellowish or cutaneous nodule or papule. They may also present as multiple skin nodules, less commonly as a deep subcutaneous mass, or even more rarely as a systemic, potentially fatal process. They often arise in the skin of the face, head, neck, and trunk but are a rare finding in the hand, reported only on a case-by-case basis. Even though juvenile xanthogranulomas are benign, their identification should not be dismissed and requires further consideration. Although our patient was fortunate to have a solitary hand lesion that was excised with clear margins and without systemic involvement, it remains imperative that the operating surgeon is aware of, and sends appropriate referrals for work-up of, the associations that may be seen in these cases.