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Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature.
Taiwan J Obstet Gynecol. 2022 Sep; 61(5):889-895.TJ

Abstract

OBJECTIVE

To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon.

CASE REPORT

A 66-year-old woman presented with lower abdominal pain. Pelvic examination showed tenderness over the lower abdominal region without cervical discharge. Per-rectal examination showed a hard tumor on the posterior uterine wall, while ultrasonography showed a tumor-like mass extending from the posterior uterine wall to the rectum. Magnetic resonance imaging showed signs of endometrial cancer invading the rectum. However, the tumor markers carbohydrate antigen (CA) 125, CA199, and carcinoembryonic antigen were in the normal range. Cystoscopy, panendoscopy, and colonoscopy showed no significant findings. On performing exploratory laparotomy, we observed pus and severe adhesion on the posterior uterine wall and rectum. Hysterectomy, bilateral adnexectomy, colectomy, and partial left ureter resection were performed. The final pathology showed XI. The pus culture revealed Klebsiella pneumonia and PCR revealed nocardiosis. The patient received 2 weeks of antibiotic treatment and was discharged thereafter.

CONCLUSION

XI in elderly women is rare, and hence, differential diagnoses should be carefully considered.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan.Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan.Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan; Insitutes of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address: dah1003@yahoo.com.tw.

Pub Type(s)

Case Reports
Review

Language

eng

PubMed ID

36088063

Citation

Shen, Ting-An, et al. "Xanthogranulomatous Inflammation Caused By K. Pneumonia and Nocardiosis Mimicking a Uterine Tumor and Invading the Ureter and Colon: a Case Report and Review of the Literature." Taiwanese Journal of Obstetrics & Gynecology, vol. 61, no. 5, 2022, pp. 889-895.
Shen TA, Hsu YH, Ding DC. Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature. Taiwan J Obstet Gynecol. 2022;61(5):889-895.
Shen, T. A., Hsu, Y. H., & Ding, D. C. (2022). Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature. Taiwanese Journal of Obstetrics & Gynecology, 61(5), 889-895. https://doi.org/10.1016/j.tjog.2021.12.006
Shen TA, Hsu YH, Ding DC. Xanthogranulomatous Inflammation Caused By K. Pneumonia and Nocardiosis Mimicking a Uterine Tumor and Invading the Ureter and Colon: a Case Report and Review of the Literature. Taiwan J Obstet Gynecol. 2022;61(5):889-895. PubMed PMID: 36088063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Xanthogranulomatous inflammation caused by K. pneumonia and nocardiosis mimicking a uterine tumor and invading the ureter and colon: A case report and review of the literature. AU - Shen,Ting-An, AU - Hsu,Yung-Hsiang, AU - Ding,Dah-Ching, PY - 2021/12/29/accepted PY - 2022/9/10/entrez PY - 2022/9/11/pubmed PY - 2022/9/11/medline KW - Cancer KW - Oophoritis KW - Ovary KW - Sarcoma KW - Xanthogranulomatous inflammation SP - 889 EP - 895 JF - Taiwanese journal of obstetrics & gynecology JO - Taiwan J Obstet Gynecol VL - 61 IS - 5 N2 - OBJECTIVE: To present a rare case of xanthogranulomatous inflammation (XI) mimicking a uterine sarcoma and invading the ureter and colon. CASE REPORT: A 66-year-old woman presented with lower abdominal pain. Pelvic examination showed tenderness over the lower abdominal region without cervical discharge. Per-rectal examination showed a hard tumor on the posterior uterine wall, while ultrasonography showed a tumor-like mass extending from the posterior uterine wall to the rectum. Magnetic resonance imaging showed signs of endometrial cancer invading the rectum. However, the tumor markers carbohydrate antigen (CA) 125, CA199, and carcinoembryonic antigen were in the normal range. Cystoscopy, panendoscopy, and colonoscopy showed no significant findings. On performing exploratory laparotomy, we observed pus and severe adhesion on the posterior uterine wall and rectum. Hysterectomy, bilateral adnexectomy, colectomy, and partial left ureter resection were performed. The final pathology showed XI. The pus culture revealed Klebsiella pneumonia and PCR revealed nocardiosis. The patient received 2 weeks of antibiotic treatment and was discharged thereafter. CONCLUSION: XI in elderly women is rare, and hence, differential diagnoses should be carefully considered. SN - 1875-6263 UR - https://www.unboundmedicine.com/medline/citation/36088063/Xanthogranulomatous_inflammation_caused_by_K__pneumonia_and_nocardiosis_mimicking_a_uterine_tumor_and_invading_the_ureter_and_colon:_A_case_report_and_review_of_the_literature_ L2 - https://antibodies.cancer.gov/detail/CPTC-MUC16-1 DB - PRIME DP - Unbound Medicine ER -