AB202. Benign cyst with xanthogranulomatous inflammation involving the transverse colon and the common iliac artery

Background: Xanthogranulomatous inflammation (XGI) is an extremely rare inflammatory process that can involve any organ system, most commonly kidney and gallbladder. However, the incidence of XGI involving the gastrointestinal tract and mesentery is unknown.

Methods: We report a case of XGI in a 29-year-old male who presented to Galway University Hospital with 10-day history of pyrexia and abdominal pain after undergoing a liposuction procedure in India.

Results: Radiologic investigations revealed a large cystic abdominal mass. The patient was treated conservatively for multiple subcutaneous collections for 3 weeks and was subsequently discharged home. The patient developed progressive focal neurological signs and dysuria due to cystic compression of the cutaneous nerves of the thigh and bladder respectively. Therefore, a laparotomy was performed. The cystic mass was decompressed and the majority removed leaving a small cuff around the great vessels. Histology confirmed a benign cyst with marked xanthogranulomatous inflammation.

Conclusions: We report a case of XGI forming mesenteric cyst involving the transverse colon, presenting with sepsis and intra-abdominal mass. Although rare, differential diagnosis would be infective, mesenteric or malignant cysts.

Keywords: Cyst; transverse colon; xanthogranulomatous inflammation