Contrast-enhanced Ultrasound of Xanthogranulomatous Endometritis: A Case Report and Literature Review

Xanthogranulomatous endometritis (XGE) is a rare inflammatory disease, which can easily misdiagnose as cancer in imaging diagnosis. Diagnosis of XGE relies on histopathological examination and immunohistochemistry. In this study, a case of a 72-year-old female with XGE and elevated CA125 is presented, which was misdiagnosed as endometrial cancer in transvaginal ultrasonography and ovarian cystadenocarcinoma in CT. However, the features of XGE on the contrast-enhanced ultrasound (CEUS) were different from that of endometrial cancer. The patient finally underwent laparoscopic hysterectomy and bilateral adnexectomy. The histopathological examination and immunohistochemistry suggested xanthogranulomatous endometritis (histiocytic endometritis). This case report manifests that CEUS may be a new noninvasive diagnostic method for XGE, which may reduce extensive tissue sampling and unnecessary hysterectomies for patients.