While xanthosarcomas are rare, there are weightier reasons for making this report. The occurrence of two widely separated tumors was responsible for a consideration of (1) the problem of metastasis (involving the question of genuine malignancy) versus pluricentric tumors and (2) complex problems of internal medicine ranging from the embryologic, developmental aspects of tumors of the acoustic nerve to the diversified changes that may occur in tumors incidental to hypercholesteremia.
Thus, with xanthomatous tumor-like masses occurring (1) in granulation tissue (Garrett1), (2) in diabetic and pseudodiabetic conditions (Weidman and Schaffer2), (3) with adenocarcinoma of the stomach, (4) with adenocarcinoma of the duodenal papillae, (5) with strictures of the bile ducts, (6) with acute pancreatitis and (7) with hydatid cysts, the attention of the surgeon must be drawn to the field of disturbed general lipid metabolism, which most of the lesions just mentioned can connote.
In short, it is
FRED D. WEIDMAN. XANTHOSARCOMA OF THE CHEEK SUCCEEDING XANTHOSARCOMA OF THE FOREARMMULTIPLE TUMORS VERSUS METASTASIS. Arch Surg. 1937;34(5):792–827. doi:10.1001/archsurg.1937.01190110035002