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Xanthogranulomatous pyelonephritis presenting with a left flank mass.
Uwais B Zaid1, Sima P Porten1, Nadya M Cinman1
1Department of Urology, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143, USA.
Case Reports in Medicine
|December 25, 2013
Summary
Xanthogranulomatous pyelonephritis (XGP) can present as a large flank mass with kidney damage. This case highlights a severe presentation requiring surgical intervention for end-stage kidney disease.
Area of Science:
- Nephrology
- Urology
- Radiology
Background:
- Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic bacterial infection of the kidney.
- It is characterized by lipid-laden macrophages and often associated with obstruction and infection.
Purpose of the Study:
- To present a case of XGP with a large flank mass and complex imaging findings.
- To illustrate the diagnostic and management challenges of severe XGP.
Main Methods:
- Case report detailing clinical presentation, imaging (CT abdomen/pelvis), and surgical intervention.
- Pathological examination of the resected kidney.
Main Results:
- A large left-sided flank mass (18 × 12 cm) was identified.
- CT revealed extensive kidney parenchyma replacement by fluid and gas collections, a staghorn calculus, and a renal-abscess fistula.
- Pathology confirmed end-stage kidney with scarring consistent with XGP.
Conclusions:
- XGP can manifest with significant mass effect and destructive kidney changes.
- Prompt surgical intervention may be necessary for advanced cases.
- This case underscores the importance of considering XGP in the differential diagnosis of complex renal masses.
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