Abstract

Background: Xanthogranulomatous salpingo-oophoritis is an infrequent and challenging diagnosis of the female genital tract. It involves the destruction of the fallopian tube and ovarian tissue by infiltrating inflammatory cells comprising lipid laden macrophages, lymphocytes, plasma cells, and multinucleated giant cells. While more commonly found in gall bladder and kidney, its occurence in female genital tract is rare. This is a case of Xanthogranulomatous salphingo-oophoritis in a 48 year woman who presented with chronic lower abdomen pain and frequent heavy menses for two months. On per abdomen examination a non tender 24 weeks size mass was felt and on vaginal examination the same mass was appreciated, seperate from the uterus. PAP was reported NILM. Ultrasound revealed uterine adenomyoma with bilateral endometrioma of ovaries and associated left hydrosalphinx. Patient underwent hysterectomy with bilateral salphingo-oopherectomy. Histopathological examination revealed uterine adenomyosis, chronic cervicitis with xanthogranulomatous salpingo-oophoritis. The patient recovered well and doing good on follow-up. Conclusion: Xanthogranulomatous salpingo-oophoritis, though rare is a significant entity because clinically it can mimic chronic pelvic inflammatory disease or endometrioma and even in some cases malignancy. Even clinical examination and imaging might not help much. Therefore, knowledge and awareness about the condition with the help of histopathology can clinch the diagnosis and also prevent radical cancer surgery.

• 1.   Manandhar T, Rajbhandari S, Thakur A, Bhandari S, Dhakal S. Xanthogranulomatous SalpingoOophoritis Presenting as an Ovarian Malignancy. Cureus. 2021 Feb 15;13 2):e13363. doi: 10.7759/cureus.13363. PMID: 33754094; PMCID:PMC7971699.
• 2.   Patel KA, Chothani KP, Patel B, Lanjewar DN: Xanthogranulomatous salpingo-oophoritis: a case report and review of literature. Int J Reprod Contracept Obstet Gynecol. 2020, 9:4316-9. 10.18203/2320-1770.ijrcog20204334.
• 3.   Rathore R, Chauhan S, Mendiratta S, Sharma R, Nain M, Sarin N. Xantogranulomatous Salpingo Oophritis, Lessons Learnt: Report of Two Cases With Unusual Presentation. J Family Reprod Health. 2017 Sep;11(3):174-178. PMID: 30018655; PMCID: PMC6045687.
• 4.   Zhang Xs, Dong Hy, Zhang Ll, Desouki MM, Zhao C. Xanthogranulomatous Inflammation of the Female Genital Tract: Report of Three Cases. J Cancer 2012; 3:100-106. doi:10.7150/jca.3929.
• 5.   Elahi AA, Nigam A, Pujani M, et al Xanthogranulomatous oophoritis mimicking malignancy: a diagnostic dilemma Case Reports2015;2015:bcr201521064
• 6.   Gray Y, Libbey NP. Xanthogranulomatous salpingitis and oophoritis: a case report and review of the literature. Archives of pathology & laboratory medicine. 2001 Feb 1;125 (2):260-3.
• 7.   Shukla S, Pujani M, Singh SK, Pujani M. Xanthogranulomatous oophoritis associated with primary infertility and endometriosis. Indian J Pathol Microbiol. 2010 Jan-Mar;53(1):197-8. doi: 10.4103/0377-4929.59240. PMID: 20090279.
• 8.   Sharma M, Singh R, Marwaha P, Myes D, Malik N. Xanthogranulomatous Salpingo-Oophoritis as a Rare Presentation in Pelvic Inflammatory Disease. Cureus. 2024 Feb 6;16(2):e53693. doi: 10.7759/cureus.53693. PMID: 38455808; PMCID: PMC10918308.
• 9.   Walther M, Glenn JF, Vellios F. Xanthogranulomatous cystitis. The Journal of urology. 1985 Oct 1;134(4):745-6.
• 10.   McCluggage WG, Allen DC. Ovarian granulomas: a report of 32 cases. J Clin Pathol. 1997 Apr;50(4):324-7. doi: 10.1136/jcp.50.4.324. PMID: 9215150; PMCID: PMC499884.
• 11.   Kunakemakorn P, Ontai G, Balin H. Pelvic inflammatory pseudotumor: a case report. American journal of obstetrics and gynecology. 1976 Sep 1;126(2):286-7.

Data Sharing Statement

Funding