Xanthogranulomatous pyelonephritis (XGPN) is a very rare, unusual variant of pyelonephritis characterized by destruction of renal parenchyma. It usually occurs in adults with a history of recurrent urinary tract infections. The condition is rare in children and the disease can imitate renal tumors. Here, we describe a 12-year-old boy who presented with abdominal pain. He did not have any history of urinary tract infection. Computed tomography and magnetic resonance imaging showed a cystic lesion in the left upper kidney. The patient underwent radical nephrectomy with a provisional diagnosis of Wilms tumor however histopathological examination of specimen revealed XGPN. Xanthogranulomatous pyelonephritis should be kept in mind in the differential diagnosis of renal lesions in childhood, during surgery if any suspicion from the diagnosis, a frozen biopsy should have been taken.
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1. G o l d m a n S M , H a r t m a n D S , Fi s h m a n E K , Finizio JP, Gatewood OM, Siegelman SS. CT of xanthogranulomatous pyelonephritis: radiologicpathologic correlation. AJR Am J Roentgenol 1984; 142: 963-969.
2. Cakmakci H, Tasdelen N, Obuz F, Yilmaz E, Kovanlikaya A. Pediatric focal xanthogranulomatous pyelonephritis: dynamic contrast-enhanced MRI findings. Clin Imaging 2002; 26: 183-186 . 3. Al-Ghazo MA, Ghalayini IF, Matalka II, Al-Kaisi NS, Khader YS. Xanthogranulomatous pyelonephritis: analysis of 18 cases. Asian J Surg 2006; 29: 257-261.
4. Dell’Aprovitola N, Guarino S, Del Vecchio W, et al. Xanthogranulomatous pyelonephritis mimicking a renal cell carcinoma: a unique and challenging case. Acta Radiol Short Rep 2014; 3: 1-4.
5. Zaid UB, Porten SP, Cinman NM, Sanford TH, Breyer BN. Xanthogranulomatous pyelonephritis presenting with a left flank mass. Case Rep Med 2013;11: 1-3.
6. Mnif MF, Kamoun M, Kacem FH et al. Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management. Indian J Endocrinol Metab 2013;17: 442-445
7. Singh R, Gupta G, Kumar P, Kotasthane DS. Xanthogranulomatous pyelonephritis in a male child- -a case report with a brief review of literature. J Indian Med Assoc 2012; 110: 739-740.
8. D w i v e d i U S , G o y a l N K , S a x e n a V, e t a l . Xanthogranulomatous pyelonephritis: our experience with review of published reports ANZ J Surg 2006; 76: 1007-1009.
9. G u p t a S , A r a y a C E , D h a r n i d h a r k a V R . Xanthogranulomatous pyelonephritis in pediatric patients: case report and review of literature. J Pediatr Urol 2010; 6: 355-358.
10. Khalid S, Zaheer S, Zaheer S, Ahmad I, Khalid M.. Xanthogranulomatous pyelonephritis: rare presentation of a rare disease. South Asian J Cancer 2013; 2: 4.
11. Kuo CC, Wu CF, Huang CC et al. Xanthogranulomatous pyelonephritis: critical analysis of 30 patients. Int Urol Nephrol 2011; 43: 15-22.
12. Zugor V, Schott GE, Labanaris AP. Xanthogranulomatous pyelonephritis in childhood: a critical analysis of 10 cases and of the literature. Urology 2007; 70: 157-160.
13. Khalid M, Ahmad M, Siddiqui MA, Khalid S. Diagnostic difficulties in diffuse xanthogranulomatous pyelonephritis: A case report and re
14. N a n d e d k a r S S , M a l u k a n i K , S a k h i P. Xanthogranulomatous pyelonephritis masquerading as a tumor in an infant. Indian J Urol 2014; 30: 354- 356.
15. S h a h K , Pa r i k h M , G h a r i a P, M o d i P R . Xanthogranulomatous pyelonephritis-mimicking renal mass in 5-month-old child. Urology 2012; 79: 1360- 1362.