DOI -10.21276/obgyn.2019.5.2.16 ISSN Print – 2454-2334; ISSN Online – 2454-2342 Surprisingly benign histopathology in a case of malignant looking ovary Rachna Agarwal, Alpana Singh, AG Radhika, Garima Vats Correspondence: Dr Rachna Agarwal, Professor, Department of Obstetrics and Gynaecology, University College of Medical Sciences & GTB Hospital, Delhi – 110095, India; Email - rachna_anila@yahoo.co.in Distributed under Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) ABSTRACT Xanthogranuloma is a non-neoplastic presentation of chronic inflammation commonly seen in gallbladder, kidneys and rarely seen in genital organs. Herein, we report a case of xanthogranulomatous oophoritis in a 45 year female who presented with lower abdominal pain and backache. There was an ill defined mass around 14 weeks size of gravid uterus. USG and CECT scan of abdomen confirmed it to be enlarged multiloculated right ovary 7.2×6.5×6.5 cms with multiple enhancing thick septations. CA125, CA19-9 and LDH were raised. The mass was clinically and radiologically misdiagnosed as ovarian neoplasm. Staging laparatomy was done. Histopathological findings revealed characteristics features of xanthograulomatous oophoritis. Xanthogranulomatous oophoritis should be kept in mind while dealing with cases of ovarian tumors to prevent misdiagnosis of malignancy and to avoid radical surgeries. Keywords: Ovarian neoplasm, xanthograulomatous inflammation, xanthograulomatous oophoritis. Xanthograulomatous inflammation is an uncommon type of chronic inflammation in which the affected organ is destroyed and is replaced by large number of lipid laden macrophages with an admixture of lymphocytes, plasma cells, multinucleated giant cells and neutrophils 1 . The most common affected organs are the kidneys and gall bladder followed by anorectal area, bone, stomach and testes 2 . The female genital tract involvement is rare and mostly confined to endometrium 3 . However, involvement of vagina, cervix, fallopian tube and ovary has also been documented. Only few cases involving the ovary have been reported upto date 3 . Herein, we report a case of xanthogranulomatous oophoritis in a 45 year female who was clinically and radiologically misdiagnosed as ovarian neoplasm. Histopathological findings revealed characteristics features of xanthograulomatous oophoritis. Case report A 45 years old female P 4 L 4 A 2 presented with lower abdominal pain and backache since 8 days. On per abdominal examination, there was an ill defined mass around 14 wks size gravid uterus arising from the pelvis and occupying whole of lower abdomen extending to right side. Per vaginal examination revealed same mass in midline and extending to right adnexa, firm, non tender and with restricted mobility. Uterus was felt separately CASE REPORT Received: 10 th July 2018. Accepted: 23 rd Decmber 2018. Agarwal R, Singh A, Radhika AG, Vats G. Surprisingly benign histopathology in a case of malignant looking ovary. The New Indian Journal of OBGYN. 2019; 5(2): 142-5