Inflammatory pseudotumor (plasma cell granuloma) of the pelvic cavity. A case report.

BACKGROUND Inflammatory pseudotumor (IPT), also called plasma cell granuloma, is a rare, benign, tumorlike lesion composed of proliferating spindle cells admixed with an inflammatory infiltrate and usually affecting the lungs. Other locations can also be affected. CASE An 18-year-old woman complained of abdominal pain and discomfort. Sonographic evaluation revealed a hyperechogenic mass measuring 32 x 36 mm and located between the right ovary and uterus. CBC showed mild leukocytosis. Laparoscopic resection of the mass revealed histologically an inflammatory pseudotumor. CONCLUSION IPT may occur at any age and affects both sexes equally. The clinical presentation usually includes fever, leukocytosis and weight loss, although many cases are asymptomatic, especially in the pelvis. The lesion usually presents with distinct borders and a firm consistency and is tan to white. The course of IPT is usually benign and self-limited. Surgical resection is the most common therapy, whereas corticosteroids and, in rare cases, chemotherapy are used. Recurrences have been described. Because of the rarity of this condition, it is unusual for the diagnosis to be made preoperatively.