Xanthogranulomatous oophoritis - masquerading as ova - rian neoplasm : report of two cases

Neeru Gupta*, Chhaya Gupta Department of Pathology, Sri Balaji Action Medical Institute, Paschim vihar, New Delhi, India Xanthogranulomatous oophritis is an unusual chronic inflammatory condition which clinically presents as a mass like lesion in the pelvic cavity. It invades the surrounding tissue and thus mimics like a tumor. Patients with xanthogranulomatous oophoritis presents with lower abdominal or suprapubic pain, fever, menorrhagia, vaginal bleeding, adnexal tenderness and rarely as a pelvic mass. Only a few cases of this entity have been reported in India. We report two cases of xanthogranulomatous inflammation of the female genital tract presenting with unilateral ovarian masses having clinical and radiological suspicion of an ovarian tumor. Both patients underwent panhystrectomy. Gross examination revealed enlarged unilateral ovaries with multiloculated cystic cavities on cut surface. Histopathological examination revealed massive infiltration of the ovarian tissue by lipid laden histiocytes and mixed inflammatory infiltrate suggesting a diagnosis of xanthogranulomatous oophoritis. These cases mimicked as malignancy and are of interest in view of their rarity. C-25 Xanthogranulomatous oophoritis Annals of Pathology and Laboratory Medicine, Vol. 02, No. 01, Jan-Mar 2015 Introduction Xanthogranulomatous inflammation is a specific type of chronic inflammatory lesion characterized by presence of large number of lipid laden histiocytes admixed with other inflammatory cells leading to destruction of the affected tissue. [1] . This lesion is documented in gall bladder, stomach, anorectal area, bone, urinary bladder, testis, epididymis, ovary, vagina and endometrium. [2] Although xanthogranulomatous inflammation is reported in the female genital tract but only few cases of ovarian involvement have been seen. Only 13 cases of xanthogranulomatous inflammation in the ovary and fallopian tube and 15 cases in the endometrium have been reported in the literature. [2,3,4,5] This inflammatory lesion shows foamy histiocytes (lipid laden), lymphocytes, plasma cells and neutrophils infiltrating and destroying the affected tissue. Xanthogranulomatous oophoritis occurs mostly in third decade with age group of 30-35 years. [3, 4] Clinical presentation of lower abdominal or suprapubic pain, pyrexia, abnormal vaginal bleeding or spotting, adnexal tenderness and pelvic mass as the common signs and symptoms observed in these patients prompting them to seek medical attention [1, 4] We report two cases of xanthogranulomatous oophoritis in 30 and 31 year old females because of their close resemblance to malignancy and rarity