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Chronic pyonephrosis associated with renal neovascularisation.

N Eke1, R C Echem

  • 1Urology Unit, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.

African Journal of Medicine and Medical Sciences
|April 12, 2005
PubMed
Summary

Chronic pyonephrosis can mimic kidney cancer on imaging, leading to delayed treatment. This case highlights the importance of considering benign conditions that present as renal masses.

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Area of Science:

  • Nephrology
  • Urology
  • Pathology

Background:

  • Renal tract infections encompass a range of conditions, with severe kidney damage sometimes leading to radiological findings suggestive of malignancy.
  • Chronic pyonephrosis, a severe kidney infection, can present with symptoms mimicking malignant renal tumors.

Observation:

  • A 25-year-old woman with a 5-year history of left lumbar pain, urinary frequency, and hematuria presented with a non-functioning left kidney on intravenous urography, containing a calculus.
  • Surgical exploration revealed a large renal mass with neovascularization, invading the colonic mesentery, which initially appeared malignant.

Findings:

  • The final pathological diagnosis was chronic pyonephrosis, not renal cell carcinoma.
  • Neovascularization, typically associated with malignancy and angiogenesis, was observed in this case of chronic inflammation.

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Implications:

  • This case underscores the need to consider benign conditions like chronic pyonephrosis in the differential diagnosis of renal masses, even with concerning imaging features.
  • Prophylactic antibiotics for nephrectomy and mandatory histopathological examination of surgical specimens are recommended to ensure accurate diagnosis and patient safety.