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Non-dermatologic isolated intracranial necrobiotic xanthogranuloma
  1. Daniel Popoola1,
  2. Steven B Housley2,3,
  3. Wady T Jacoby1,
  4. Jaims Lim2,3,
  5. Justin M Cappuzzo2,3 and
  6. Elad I Levy4,5
  1. 1University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  2. 2Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  3. 3Neurosurgery, Buffalo General Medical Center, Buffalo, New York, USA
  4. 4Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
  5. 5Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
  1. Correspondence to Dr Elad I Levy; ELevy{at}


Necrobiotic xanthogranuloma is a condition that was first identified in 1980 based on its characteristic histological identity, and it has been known since then as a dermatologic manifestation of an underlying systemic dysproteinemia. Intracranial manifestation is a rare presentation of this condition and has been reported only once in its more than 40 years of existence. Herein and to our knowledge, we report the second observation of an intracranial manifestation and, surprisingly, the first case without the expected dermatologic and systemic dysproteinemia associations. This case identifies an existing knowledge gap in our understanding of necrobiotic xanthogranuloma and emphasises the need for further research into understanding the presentation, comorbidities and management of this condition.

  • dermatology
  • pathology
  • neurosurgery

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  • Contributors DP, SBH, WTJ, JL, JMC and EIL were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. DP, SBH, WTJ, JL, JMC and EIL gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests Cappuzzo—Consulting Fees: Cerenovus, J Integra Lifesciences, Corp.; MIVI Neuroscience, Inc.; Penumbra, Inc.; Stryker, Corp. Support for attending meetings and/or travel: Stryker, Corp.; Penumbra, Inc. EIL— Shareholder/Ownership Interest: NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, Three Rivers Medical; Patent: Bone Scalpel; Honorarium for Training Chief Medical Officer: Haniva Technology; National PI: Medtronic—Steering Committees for SWIFT Prime and SWIFT Direct Trials; Site PI Study: MicroVention (CONFIDENCE Study) Medtronic (STRATIS Study-Sub 1); Advisory Board: Stryker (AIS Clinical Advisory Board), NeXtGen Biologics, MEDX, Cognition Medical; Endostream Medical, IRRAS AB (Consultant/Advisory Board, Medical Legal Review: EIL renders medical/legal opinions as an expert witness); Leadership or fiduciary roles in other board society, committee, or advocacy group, paid and unpaid: CNS, ABNS, UBNS.

  • Provenance and peer review Not commissioned; externally peer reviewed.