Xanthogranulomatous appendicitis: A comprehensive literature review

Area of Science:

• Gastroenterology
• Pathology
• Surgical Oncology

Background:

• Xanthogranulomatous inflammation involves lipid-laden macrophages and inflammatory cells.
• It can mimic neoplastic processes, posing diagnostic challenges.

Purpose of the Study:

• To conduct a literature review on xanthogranulomatous appendicitis (XGA).
• To analyze the clinical presentation, diagnosis, and management of XGA.

Main Methods:

• A comprehensive literature search was performed using PubMed, MEDLINE, Google Scholar, and Google.
• Keywords included "appendix vermiformis," "appendectomy," "acute appendicitis," and "XGA."
• Retrospective analysis of 29 articles involving 38 patients with XGA.

Main Results:

• XGA affects patients aged 3 to 78 years, with a slight female predominance (52.6%).
• 25 patients presented with appendicitis; 13 underwent surgery for ileocecal tumoral lesions.
• 16 patients required interval appendectomy, and some needed bowel resection.

Conclusions:

• Xanthogranulomatous appendicitis is rare and presents diagnostic and therapeutic dilemmas.
• It often mimics tumoral lesions, leading to delayed diagnosis and potential bowel resection.
• XGA is typically diagnosed retrospectively on surgical pathology, lacking unique preoperative features.