Xantogranulomatous pyelonephritis: The missed diagnosis.

Xantogranulomatous pyelonephritis: The missed diagnosis.

Int J Surg Case Rep. 2015 Nov 30;18:21-23

Authors: El Abiad Y, Dehayni Y, Qarro A, Balla B, Ammani A, Alami M

Abstract
INTRODUCTION: Xantogranulomatous pyelonephritis (XGPN) is a rare chronic inflammatory disease of the kidney that can be focal or diffuse with the focal form imitating greatly renal cell carcinoma (RCC).
PRESENTATION OF CASE: We report a challenging clinical case of a 38-year old male with right flank pain persisting for 3-months, imaging showed an 8cm heterogenous mass of the upper pole of the right kidney and invading the liver. A right radical nephrectomy including the adrenal in the resection was performed under the tentative diagnosis of renal cell carcinoma (RCC) whereas histology revealed focal XGPN.
DISCUSSION: Preoperative diagnosis of focal XGPN was difficult because of radiological similarities to RCC and lack of history of stone disease or urinary tract infection.
CONCLUSION: This case highlights the need to include XGPN in the differential diagnosis of RCC even in the era of modern imaging.

PMID: 26684864 [PubMed - as supplied by publisher]

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