Lipid-rich foamy macrophages intermingled with lymphocytes, plasma cells, neutrophils, and eosinophils are the hallmark of xanthogranulomatous inflammation. Due to its capacity for mass formation and destructiveness, it is an uncommon entity that mimics neoplasm. Rarely, it is detected in the female genital system; however, it is most frequently seen in the kidney and gallbladder. It is associated with endometriosis, uterine leiomyoma, ovarian hemangioma, and can occur secondary to diverticulitis, chronic bacterial infections, ineffective antibiotic treatment, and uterine artery embolization. The annual incidence of pheochromocytoma is 0.8 per 100,000 person-years and it is a catecholamine-secreting tumor that arises from chromaffin cells in the adrenal medulla. Synchronous presentation of xanthogranulomatous salpingo-oophoritis (XSO) with pheochromocytoma has not been described so far. Hence, we report a series of two such cases mimicking malignancy and have discussed the pathogenesis of the above association.
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