Different Presentations of Juvenile Xanthogranuloma in Hong Kong

1. Henry Lau¹
2. Wilson Yip¹
3. Allie Lee²
4. Dorothy Fan²
5. Connie Lai¹
6. Clement Tham¹

¹Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, People's Republic of China
²Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China

Purpose
To report three cases of juvenile xanthogranuloma with different presentations in Hong Kong.

Methods
Three cases of juvenile xanthogranuloma from two ophthalmology departments were reviewed. Clinical histories, ophthalmic examination, physical examination, investigations and treatment of these cases were described

Results
The first case was a four-month-old boy who presented with spontaneous hyphema with secondary glaucoma. He was treated with intensive topical steroid and anti-glaucomatous eye drops. The hyphema gradually resolved and intraocular pressure was under control. Biopsy of his scalp mass confirmed the diagnosis of juvenile xanthogranuloma.
The second case was a 31-month-old boy who presented with a scleral mass. Excisional biopsy was performed under general anaesthesia. Histological examination confirmed juvenile xanthogranuloma.
The third case was a 20-month-old boy who presented with a skin nodule over his back. Skin biopsy confirmed juvenile xanthogranuloma. He did not have other ocular sign.
All the three cases have good visual outcome after treatment.

Conclusion
Presentation of juvenile xanthogranuloma can be very different. Treatment modalities are unique with respect to different clinical presentations. Biopsy of suspected lesion is essential in confirming the diagnosis.