Xanthogranuloma of the vagina
Gita P. Gidwani, M.D.
Department of Gynecology, Department of Pediatrics and Adolescent Medicine
Lester A. Ballard, M.D.
Department of Gynecology
Gwynn L. Jelden, M.D.
Department of Radiation Therapy
Ian C. Lavery, M.D.
Department of Colon and Rectal Surgery
Xanthogranuloma is an unusual tumor that affects the ovary, mesentery, anal wall, kidney, and retroperitoneum.1–5 To our knowledge, only 19 cases have been reported.
We report a case of xanthogranuloma of the rectovaginal septum with presenting symptoms of paravaginal tumor. The patient was treated with radiation and surgery.Case report
A 30-year-old woman, gravida 2, para 2, was referred to the Cleveland Clinic for a large paravaginal mass, which had increased in size in the previous 6 months. Because of the mass, intercourse was difficult. The patient had the mass for 7 years. It had first been noticed during her second pregnancy. A low segment cesarean section had been performed for soft tissue dystocia because the size of the mass had increased. At that time a tubal ligation was also done.
Based on pathologic findings the diagnosis was xanthogranuloma. The lesion regressed after delivery. The local gynecologist had examined her regularly for the past 4 years and had noted an increase in the mass in the 6 months preceding referral to the Cleveland Clinic. Her husband was unable to achieve deep penetration during intercourse.
Examination at the Cleveland Clinic in June 1977 revealed a 30-year-old woman in no acute distress. On pelvic examination, a firm, rubbery mass about 13 × 10 cm was palpated in the right paravaginal area through the anterior and posterior walls of the vagina. The vaginal mucous membrane overlying the mass was mobile and nonulcerated. The top of the mass could not be reached and . . .