Xanthogranulomatous oophoritis: malignant appearance, benign pathology.

Area of Science:

• Gynecologic Pathology
• Reproductive Medicine
• Surgical Oncology

Background:

• Xanthogranulomatous oophoritis (XO) is a rare inflammatory condition of the female genital tract.
• It presents with non-specific symptoms and imaging findings, closely mimicking ovarian malignancy.
• Histologically, XO is characterized by lipid-laden macrophages, chronic inflammation, and necrosis.

Purpose of the Study:

• To report a case of Xanthogranulomatous oophoritis (XO) with unusual extension.
• To highlight the diagnostic challenges posed by XO due to its similarity to ovarian cancer.
• To emphasize the importance of considering XO in the differential diagnosis of adnexal masses.

Main Methods:

• Case report of a postmenopausal woman presenting with a complex ovarian mass.
• Diagnostic evaluation included CT imaging and surgical intervention.
• Histopathological examination confirmed Xanthogranulomatous oophoritis.
• Intraoperative cultures identified *Bacteroides fragilis*.

Main Results:

• The patient was diagnosed with XO involving the ovary, uterine wall, and peri-appendiceal region.
• Surgical intervention and postoperative recovery were uneventful.
• The presence of *Bacteroides fragilis* suggests a possible infectious etiology for XO.

Conclusions:

• Xanthogranulomatous oophoritis remains a diagnostic challenge due to its mimicry of ovarian malignancy.
• Considering XO in patients with adnexal masses, especially those with a history of pelvic inflammation, is crucial.
• Recognition of XO can prevent unnecessary radical surgeries and guide management strategies.