Case Report

Central Nervous System Xanthoma Disseminatum: Response to 2CdA in an Adolescent

Table 1

Summary of published responses to 2CdA in xanthoma disseminatum.

ReferencePatient2CdA regimenOutcomeToxicities

Khezri 2011 [12]Series of 8 patients: All with diffuse skin involvement; 1 patient with additional pituitary and airway involvement; 1 patient with pituitary, adenoid, and soft palate involvement5 out of 8 patients received treatment: 0.14 mg/kg/day x 5 days every 4 weeks x 5–8 cyclesAll patients had substantial improvement in established lesions; no new lesions in follow-up period (3 months to 8 years)Joint pain and night sweats in 1 patient; no serious adverse effects reported

Gupta 2016 [21]23yo M with diffuse skin involvement and DI0.14 mg/kg/day x 5 days every 1 month x 8 cyclesStopped developing lesions after cycle 2; marked improvement after cycle 5None reported

Adisen 2017 [22]19yo F with diffuse skin involvement0.14 mg/kg/day x 5 days every 1 month x 7 cyclesResolution of many lesions; residual hyperpigmented macules remaining; no new lesions in 2-year follow-upNone reported

Briones 2018 [23]55yo M with diffuse skin and laryngopharyngeal involvementPresumed 0.14 mg/kg/day for 5 days, every 1 month X 3 cycles (6-8 cycles planned, stopped due to thrombocytopenia)Clinical resolution of changes in voice, significant improvement in skin, lip, and gingiva; complete resolution of all lesions and no new lesions at 10 months follow-uThrombocytopenia (early termination of planned therapy)

Patra 2019 [24]9yo M with diffuse skin, DI, optic atrophy, and multiple intracranial lesions0.14 mg/kg/day x 5 days every 1 month x 6 cycles30–40% flattening of skin lesions, decrease in intracranial lesion size, and improvement in diabetes insipidus and visionAsymptomatic transient leukopenia

Tuan 2019 [25]3 patients all with diffuse skin involvement and DI; 1 patient with respiratory involvement requirement tracheostomy; 1 patient with bulbar involvement0.14 mg/kg/day x 5 days every 1 month x 5–9 cyclesSignificant resolution of cutaneous and mucosal lesions; no signs of relapse after 52–66 months of follow-upNone reported

Al-Tarcheh 2020 [26]24yo F with diffuse skin, DI, tracheal, knee joint, and nasopharynx involvement0.14 mg/kg/day x 5 days every 1 month x 6 cyclesResolution of nasopharynx mass and tracheal lesion; no new skin lesions but no regression of established lesionsNone reported