अमूर्त

Ovarian cyst resulting in sigmoid colon fistula formation

Priyal Chouhan

 Statement of the Problem: Xanthogranomatous inflammation in a non-neoplastic, rare chronic inflammation that causes destruction and replacement of normal tissue with lipid laden foamy macrophages, intermixed with lymphocytes, gaunt cells and plasma cells. It most commonly involves kidney followed by gall bladder, salivary glands, stomach, bones and less commonly female genital tract. In females genital tract, it most commonly affects endometrium and can also involve vagina, cervix, Fallopian tube and ovary. Although exact ethology to this entity is unknown. Various proposed etiological factors include bacterial infection, inaffective antibiotic treatment, abnormalities of macrophages, gram negative bacteria in GUT, foreign body and long standing PID. Radiologically noted as multiloculated, cyst with irregular walls and invasion into adjacent structures as a result of which it is often confused with neoplastic aetiology. Confirmed diagnosis is done with histopathology characterised by marked proliferative fibrosis, parenchymal destruction and infiltrated foamy histiocytes intermixed with hemosiderin laden and foreign body giant cells.

Methodology & Findings: We present a case report of a 30 year female presented with vague abdominal pain and past history of small hemorrhagic ovarian cyst. She visited radiology department for follow up imaging which reveals large left ovarian cyst with fistulous communication with sigmoid colon. She underwent laparotomy and final diagnosis of xanthogranulamatous oophritis was established on histopathology.

Conclusion & Significance: It is noted that clinically and radiologically, xanthogranulamotous oophrotis mimic neoplastic disease of ovaries, and therefore it is important to discuss imaging findings, various location and extension of disease. Also, imaging in preoperative planning of surgery