title: Acute abdomen: rare and unusual presentation of right colic xanthogranulomatosis.
abstract: Xanthogranulomatous inflammation (XGI) is a disease of unknown origin, most frequently described in the kidney and gallbladder; its localization in the colorectal tract is extremely rare. The extension of the typical inflammatory process to the surrounding tissues may lead to misdiagnosis as cancer. We report the case of a 56-year-old woman presenting to the Emergency Department with pain, increased levels of α1 and α2 proteins and C-reactive protein (17.5 mg/dL; normal value 0-0.5), and a palpable mass, localized in the right lower quadrant of the abdomen. A computed tomography scan showed a large right cecal mass with necrotic areas, local inflammation of retroperitoneal fat, and enlargement of local lymph nodes. Because of the high suspicion of colic abscess as well as malignancy and worsening of the clinical condition, the patient underwent right colectomy after 4 d of antibiotic treatment. Pathology revealed xanthogranulomatous inflammation involving the ileocecal valve. We review the reports of large bowel tract XGI in the international literature.
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Addario Chieco
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Antolino
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Giaccaglia
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Centanini
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Gaetano Vincenzo
authors.initials: GV
authors.lastname: Cunsolo
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sparagna
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Uccini
authors.affiliation: Paola Addario Chieco, Laura Antolino, Valentina Giaccaglia, Francesca Centanini, Gaetano Vincenzo Cunsolo, Alessandra Sparagna, Vincenzo Ziparo, Department of General Surgery, General Surgery 1 Unit, S. Andrea University Hospital, 00189 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001706:Biopsy; D003082:Colectomy; D003085:Colic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007080:Ileocecal Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D014973:Xanthomatosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery
keywords: Abdominal abscess; Abdominal mass; Large bowel xanthogranulomatosis; Xanthogranulomatosis