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黄色肉芽肿性输卵管卵巢炎的诊断与管理挑战:1例罕见病例

Challenges in diagnosis and management of xanthogranulomatous salpingo-oophoritis: A rare case.

作者信息

Gaddi Mahalakshmi, Surpur Sahana, Kamat Vidya, Khan Zoha, Wanjari Mayur, Mittal Gaurav

机构信息

Department of Obstetrics and Gynecology, SDM College of Medical Sciences and Hospital, Dharwad, India.

Azad Jammu Kashmir Medical College, Muzaffarabad, AJK, Pakistan.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110778. doi: 10.1016/j.ijscr.2024.110778. Epub 2024 Dec 24.

Abstract

INTRODUCTION AND IMPORTANCE

Xanthogranulomatous inflammation of the female genital tract is a rare condition involving ovarian tubes characterized by chronic inflammation and destruction of pelvic organs, often mimicking pelvic malignancy.

CASE PRESENTATION

A 37-year-old female with a history of chronic kidney disease, hypertension, and treated pulmonary tuberculosis, presented with lower abdominal fullness, pain, and irregular menstrual cycles.

CLINICAL DISCUSSION

Radiological investigations revealed a significant left adnexal mass, suggesting a tubo-ovarian abscess or neoplastic lesion. Staging laparotomy was performed, and intraoperatively, the mass was found adherent to surrounding organs. A frozen section analysis indicated a benign lesion and a hysterectomy was deferred. Histopathological evaluation confirmed the diagnosis of xanthogranulomatosis salpingo-oophoritis.

CONCLUSION

This case underscores the importance of considering rare inflammatory conditions in the differential diagnosis of pelvic masses. It highlights the challenges in management, including the risk of extensive surgeries leading to infertility. Thorough investigation and accurate diagnosis are crucial for appropriate management and to minimize unnecessary interventions.

摘要

引言与重要性

女性生殖道黄色肉芽肿性炎症是一种罕见疾病,累及卵巢和输卵管,其特征为盆腔器官的慢性炎症和破坏,常酷似盆腔恶性肿瘤。

病例介绍

一名37岁女性,有慢性肾病、高血压病史且曾接受肺结核治疗,出现下腹部胀满、疼痛及月经周期不规律。

临床讨论

影像学检查发现左附件有一较大肿块,提示输卵管卵巢脓肿或肿瘤性病变。进行了分期剖腹手术,术中发现肿块与周围器官粘连。冰冻切片分析显示为良性病变,遂推迟了子宫切除术。组织病理学评估确诊为输卵管卵巢黄色肉芽肿病。

结论

该病例强调了在盆腔肿块鉴别诊断中考虑罕见炎症性疾病的重要性。它突出了管理方面的挑战,包括广泛手术导致不孕的风险。全面的检查和准确的诊断对于适当的管理以及尽量减少不必要的干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d67/11762936/4787d13ce90f/gr1.jpg

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