Xanthogranulomatous Oophoritis: Sequelae of Pelvic Inflammatory Disease in a Diabetic Woman

Background: Xanthogranulomatous inflammation is an uncommon form of chronic granulomatous inflammation commonly reported in the kidneys and gallbladder. This inflammation rarely affects the female genital tract and usually involves the endometrium. Involvement of the ovaries is a rare phenomenon known as xanthogranulomatous oophoritis (XO). Case: A 45-year-old woman presented with left-sided abdominal pain and fever that she had for a duration of 3 months prior. Her clinical diagnosis was chronic pelvic inflammatory disease, and imaging suggested a differential diagnosis of an ovarian malignancy. Results: Microscopic examination of her lesion showed lipid-laden foamy macrophages intermixed with lymphocytes, giant cells, and plasma cells, all of which were consistent with XO with organized abscess formation. Conclusions: Xanthogranulomatous inflammation of the ovary is an uncommon entity. The clinical and radiologic features of this entity can mimic an ovarian neoplasm, so XO must be considered in the differential diagnosis of ovarian lesions.