Xanthogranulomatous inflammation at uncommon anatomical sites

Xanthogranulomatous processes are rare inflammatory conditions with the characteristic pathologic feature of lipid-laden macrophages or histiocytic cells. Radiological findings are non-specific and can simulate aggressive neoplastic processes. Occasionally, these lesions are associated with benign and malignant tumors, and adhesions to adjacent organs may raise suspicion of an aggressive malignant neoplasm. We included eight cases in our study over a period of 2 years, with ages ranging from 16 to 65 years, with a mean age of 39 years and a male-to-female ratio of 1:1. Various sites of xanthogranulomatous inflammation in our study included the ovary, gallbladder, neural tissue (two cases each), appendix, and testis (one case each). A single case each of testis, appendix, and ovary presented as a mass and turned out to be Xanthogranulomatous Orchitis, appendicitis, and oophoritis, respectively, while another case of ovary showed features of xanthogranulomatous inflammation (XGI) associated with borderline mucinous cystadenoma. In both cases of gallbladder, xanthogranulomatous inflammation was observed, along with adenocarcinoma. In neural tissue, one case was associated with fibroblastic meningioma, while another was associated with Rathke’s cleft cyst. In this case series, we discussed the xanthogranulomatous inflammation at rare sites and their association with malignancy.