Tendon xanthoma: a physical manifestation of hyperlipidemia.

Tendon xanthoma, a nonneoplastic tumor of tendon is a significant physical manifestation of hyperlipidemia. These lesions may accompany rapidly progressive atherosclerosis and may signal the presence of life threatening hyperlipidemia. We have seen three patients with tendon xanthoma, and one patient was treated by surgical excision of large xanthomas arising from the substance of the extensor tendons over the metacarpophalangeal (MP) joints of the hand. Because these lesions arise from the substance of the extensor tendons complete removal may result in loss of tendon continuity and function. Surgery in the form of subtotal excision is advised for functional or cosmetic reasons. Although incomplete removal may be associated with recurrence, appropriate medical management may prevent or delay this recurrence.