The Importance of Follow-Up: Juvenile Xanthogranuloma Mimicking Cephalohematoma

Abstract

Juvenile xanthogranuloma is a type of non-Langerhans cell histiocytosis primarily affecting infants and young children. It is an uncommon disease and is rarely considered in the differential in radiological studies of infants. A case of juvenile xanthogranuloma mimicking a cephalohematoma in an otherwise healthy 3-month-old infant born via vacuum assisted delivery is presented here. At a follow-up appointment, interval growth and internal color Doppler flow with arterial waveform were noted on ultrasound. The differential diagnosis was expanded to include other well-circumscribed hypoechoic scalp lesions. At 8 months of age the lesion was surgically excised, and immunohistochemistry established the definitive diagnosis of juvenile xanthogranuloma. This case emphasizes the importance of following cephalohematomas clinically to resolution in order to exclude an alternate underlying pathology.