Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with infiltration of lipid laden foamy macrophages, lymphocytes, plasma cells leading to tissue destruction. Though exact cause is not known, uterine artery embolization, gloves dusting powder and altered lipid metabolism are hypothesized to cause the pathology. A 28-year-old parous lady with history of multiple laparotomies, known case of hypothyroidism under treatment and history of adequately treated pulmonary tuberculosis was diagnosed to have right ovarian dermoid cyst, while undergoing investigation for secondary infertility. On examination she had pallor, healthy abdominal scar, and small tender fixed mass in right fornix on internal examination. She was subjected to laparotomy and right salpingo oophorectomy with left salpingectomy was performed. Histopathological examination of the resected specimen revealed to be xanthomatous oophoritis of right ovary. As this condition mimics tuberculosis and malignancy, clinical assessment, investigation and intra operative findings with the suspicion of inflammatory aetiology help to limit the extent of surgery. Hence, this case is presented for its rare occurrence as well as its need to be differentiated from other conditions like tuberculosis and malignancy of ovary.
Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up.
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