Xanthomas of the Achilles tendon

The patients with xanthomas bilaterally in the Achilles tendons associated with type-II hyperbetalipoproteinaemia are reported. Both patients had elevated serum cholesterol, normal or slightly elevated serum triglycerides and an electrophoretic pattern of elevated beta and pre-beta lipoproteins. Subtotal resection of the tumours was found to be satisfactory in both patients with less risk of complications when compared with the earlier methods reported with total excision and reconstruction of the defect with fascial grafts. The early recognition and evaluation of the patients with hyperbetalipoproteinaemia is important because it is associated with an increased incidence of atheromatous coronary disease, often manifestated at an early age. That is why surgical interventions of tendon xanthomas must be connected with adequate medical treatment of the basic disorder in lipid metabolism