A Case of Juvenile Xanthogranuloma of the Hand in an Adolescent

Summary: 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.