Xanthogranulomatous lesion in recurrent appendicitis

Acute appendicitis (AA) is the most common acute surgical condition of the abdomen. Most resected specimens have been reported to have marked cellular infiltration, predominantly by neutrophils. By contrast, the occurrence of a xanthogranulomatous (XG) lesion is extremely rare. To date, only a few cases have been reported in the literature. Moreover, its clinical implications remain to be evaluated. Here, we report the case of a 16-year-old boy who presented with a typical history of AA for 2 days. He had no sepsis or local peritonitis. He experienced a similar attack 1 year ago, which was successfully and conservatively managed at our center. An interval appendectomy was performed 3 months later as requested by his parents. Furthermore, he responded well to the antibiotics administered. Intraoperatively, the appendix appeared fibrotic with a small lump at its base. Some adhesion was noted between the appendix and the omentum. His postoperative recovery was uneventful. Moreover, the histopathological examination of the appendix revealed features typical of an XG lesion. In addition, we conducted a literature search to establish the clinical implications of XG lesions.