Xanthogranulomatous oophorosalpingitis. Case report

Abstract

Xanthogranulomatous inflammation of the female genital tract is infrequent and is
even rarer in fallopian tubes and ovaries. We present a case of xanthogranulomatous
oophorosalpingitis in a 45-year-old female patient who consulted for left iliac fossa
pain accompanied by fever. Bimanual examination revealed a slightly enlarged
uterus with a firm, non-painful left adnexal mass, adherent to the uterus and with
limited mobility. Transvaginal ultrasound evaluation showed a heterogeneous left
ovarian tumor with thick and irregular walls, multiple septa and internal echoes
without visualization of the ovary. During surgery, dense adhesions were found
from the mass to the pelvic lateral wall, ovarian fossa, and bowel loops. The uterus
was displaced by a thick-walled, grayish-white, cystic left adnexal tumor draining
foul-smelling purulent fluid. The definitive diagnosis was xanthogranulomatous
oophorosalpingitis. This condition is a rare inflammatory process that poses
diagnostic dilemmas. Its clinical manifestations and imaging features may mimic
a malignant pelvic neoplasm, so a high index of suspicion is necessary for its
diagnosis, as a differential diagnosis in patients with complex cystic ovarian tumors.
Histopathological examination is the gold standard for diagnosis.