Background: This article reports a case of unusual association of inflammatory and neoplastic diseases of the female genital organs, emphasizing identification of the origin of the necrotizing granulomatous lesion. Case: The authors report the case of a necrotizing granulomatous lesion in the paratubal soft tissue in a 49-year-old woman with serous borderline cystadenoma of the left adnexal cyst and bilateral ovarian metastases from invasive mucinous adenocarcinoma of the gallbladder. Conclusions: The presence of a granulomatous reaction is always a diagnostic dilemma for clinicians who have to establish the cause of the granuloma. (J GYNECOL SURG 27:29)
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