Xanthoma of Tendoachilles: Management and Follow-Up

Xanthoma is a rare pseudotumor of connective tissue, consisting of histiocytes with lipid deposits. Usually, it manifests as encapsulated lobular yellowish mass, often associated with familial hypercholesterolemia (FH). We present a case of xanthoma of tendoachilles just proximal to its insertion site, secondary to FH. The patient was a 28-year-old female presenting with a 2-year history of difficulty ambulating and complaints of swelling over the posterior aspect of her left lower leg just proximal to her heel. She had a deranged lipid profile level and was started on a lipid lowering agent for 3 weeks followed by total excision of the lesion with flexor hallucis longus tendon graft augmentation. The patient was able to bear full weight at 6 weeks and could stand on her toes by 4 months. No recurrences were noted at 1 year follow-up.