Appendiceal Mass due to Xanthogranulomatous Appendicitis

Abstract

A 46-year-old woman was admitted to the obstetrics and gynecology department for an abscess in the pouch of Douglas 2 months earlier. Contrast-enhanced computed tomography (CT) showed a 2.0 × 1.5 cm² tumor with a contrast-enhancing effect on the appendix root, and lymphadenopathy around the cecum was also seen. Lower gastrointestinal endoscopy showed a reddish, swollen area around the appendix opening with white pus. No findings suggesting malignancy were obtained on biopsy. FDG-PET examination showed accumulation consistent with the mass seen on CT. Though appendiceal cancer could not be ruled out, laparoscopic ileocolic resection was planned and performed. Pathological examination showed xanthogranulomatous appendicitis. Xanthogranulomatous appendicitis is a rare disease that is difficult to distinguish from appendiceal cancer. There is no consensus on the surgical procedure, and it is necessary to carefully select it taking into account the patient's general condition and wishes.