Xanthogranulomatous Oophoritis Mimicking Malignancy
The present case has been published in the Journal of Mid-life Health.

A 24-year-old P3L3A3 female presented with the chief complaints of pain abdomen on and off, and heavy irregular cycles for 6 months. On per vaginal examination, a firm left adnexal mass could be palpated. Her blood investigations revealed microcytic hypochromic anemia, slight raise in total leukocyte count (12,000/L), raised erythrocyte sedimentation rate (ESR) (45 mm at 1st h), and slightly raised lactate dehydrogenase (490 IU/L).

Contrast-enhanced computed tomography abdomen was performed, which showed a left adnexal mass, measuring 8.5 cm × 6.8 cm × 6.3 cm, causing displacement of surrounding bowel loops and lateral displacement of uterus. The mass was multiloculated, cystic with enhancing irregular walls and multiple septations. The possibility of a benign neoplasm (cystadenoma) was suggested.

An exploratory laparotomy followed by left salpingo-oophorectomy with pus drainage followed by right tubal ligation was performed. Grossly, the tubo-ovarian mass had a pearly white capsule. On cut, it was gray-white with multiple solid cystic areas, with cysts varying from 0.2 to 3 cm in diameter.

On microscopy, a solid cystic lesion was seen, with normal ovarian tissue at the periphery. There was dense granulation tissue formation with abundant foamy macrophages, surrounded by fibrocollagenous tissue showing infiltration by lymphoplasmacytic cells and macrophages, along with congested blood vessels. Thus, a final diagnosis of xanthogranulomatous oophoritis was given.

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