RESUMEN
A 71-year-old woman with history of asthma presented with 2 months history of shortness of breath; on imaging an incidental left renal mass was noted. Subsequent renal protocol CT was obtained that showed a 4.5 cm left upper pole exophytic mass with renal vein thrombus extending into the inferior vena cava to the level of the caudate lobe concerning for renal cell carcinoma. She underwent an open left radical nephrectomy and IVC thrombectomy with subsequent postoperative pathology demonstrating xanthogranulomatous pyelonephritis without renal cell carcinoma.
Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Pielonefritis Xantogranulomatosa , Trombosis , Trombosis de la Vena , Anciano , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Renales/cirugía , Femenino , Humanos , Neoplasias Renales/complicaciones , Neoplasias Renales/diagnóstico , Neoplasias Renales/cirugía , Nefrectomía/métodos , Pielonefritis Xantogranulomatosa/diagnóstico , Pielonefritis Xantogranulomatosa/diagnóstico por imagen , Estudios Retrospectivos , Trombectomía/métodos , Trombosis/patología , Trombosis/cirugía , Vena Cava Inferior/patología , Trombosis de la Vena/complicaciones , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/cirugíaRESUMEN
Xanthogranulomatous pyelonephritis (XGP) is a chronic condition caused by granulomatous reaction to chronic renal infection. The diffuse form is more common where the kidney is enlarged while still retaining the reniform shape. The focal form is very rare and is pathologically similar to diffuse form but limited to one pole or less. To the best of our knowledge, all reported cases of XGP in the literature report a history of chronic obstructive uropathy such as calculus, stricture, or mass. We are presenting here a case report of focal XGP in a 58-year-old woman with no known history of obstructive uropathy and presented with nonspecific symptoms.