Xanthogranulomatous inflammation: a rare cause of premature ovarian failure

Xanthogranulomatous inflammation is rare, mainly involving the kidneys, histologically characterized by partial or complete replacement of the mucosa by granulation tissue with an abundance of foamy histiocytes, siderophages and multinucleated giant cells. We report an unusual presentation of xanthogranulomatous inflammation of the genital tract in a young female presenting with premature ovarian failure. A 25-year-old unmarried female presented to the gynecology OPD with amenorrhea and lump abdomen for one and half years with weight loss and mucoid discharge per rectum for 2 months. On investigating, CECT showed a heterogeneously enhancing mass lesion with solid cystic components in pelvis. Cystic components showed enhancing walls and air fluid levels. Uterus and ovaries were not seen separately. There were multiple lymph nodes in retroperitoneum. Both LH and FSH were raised to post menopausal levels (FSH-69.35, LH-64.53). A provisional diagnosis of ovarian malignancy was made and a differential diagnosis of genital tuberculosis was kept and a decision for laparotomy was taken. Intraoperatively, there was a mass arising from the right side of fundus stuck to rectum. There was a pus pocket in the tumor. The final histopathological report was suggestive of endometrioma with xanthogranulomatous inflammation involving adjacent ovary and fallopian tube. Similar content being viewed by others

Ladefoged C, Lorentzen M (1988) Xanthogranulomatous inflammation of the female genital tract. Histopathology 13:541–551 Pounder DJ, Iyer PV (1985) Xanthogranulomatous endometritis associated with endometrial Carcinoma. Arch Pathol Lab Med 109(1):73–75 Russac V, Lammers RJ (1990) Xanthogranulomatous endometritis. Report of six cases and a proposed mechanism of development. Arch Pathol Lab Med 114(9):929–932 Ashkenazy M, Lancet M, Borenstein R, Czernobilsky B (1983) Endometrial foam cells. Nonestrogenic and estrogenic. Acta Obstet Gynecol Scand 62(3):193–197 Noack F, Briese J, Stellmacher F, Hornung D, Horny H-P (2006) Lethal outcome in xanthogranulomatous endometritis. APMIS 114(5):386–388. doi:10.1111/j.1600-0463.2006.apm_281.x Pace EH, Voet RL, Melancon JT (1984) Xanthogranulomatous oophoritis: an inflammatory pseudotumor of the ovary. Int J Gynecol Pathol 3:398–402 Gray Y, Libbey NP (2001) Xanthogranulomatous salpingitis and oophritis: a case report and review of literature. Arch Pathol Lab Med 125(2):260–263 Punia RS, Aggarwal R, Amanjit R, Mohan H (2003) Xanthogranulomatous Oophoritis and salpingitis: late sequelae of inadequately treated Staphylococcal PID. Indian J Pathol Microbiol 46(1):80–81 Singh UR, Revathi G, Gita R (1995) Xanthogranulomatous oophoritis: an unusual complication of typhoid. J Obstet Gynaecol 21(5):433–436 Jung SE, Lee JM, Lee KY, Han KT, Hahn ST (2002) Xanthogranulomatous oophritis : MR imaging findings with pathological correlation. AJR Am J Roentgenol 178(3):749–751 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Singh, N., Dadhwal, V., Sharma, K.A. et al. Xanthogranulomatous inflammation: a rare cause of premature ovarian failure. Arch Gynecol Obstet 279, 729–731 (2009). https://doi.org/10.1007/s00404-008-0791-4 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-008-0791-4