Xanthogranulomatous pyelonephritis is associated with obstruction, stones and infection. CT is the mainstay of diagnosis, but appearances can mimic other conditions, including renal cell carcinoma. Nephrectomy is commonly recommended, but conservative treatment with antibiotics has been described after tissue diagnosis. We present a case of xanthogranulomatous pyelonephritis with concomitant renal cell carcinoma, which was an association that was suggested in 1988 and supported by subsequently reported cases. Conservative management of biopsy or cytology proven xanthogranulomatous pyelonephritis is unsafe, as an area of synchronous malignant tumour may be missed: we recommend it only in patients unfit for nephrectomy.
- urological surgery
- renal intervention
- renal medicine
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Contributors BFM performed the literature search and drafted the manuscript. He was involved with the patient care as an inpatient, and sought her consent for publication. LP reported the pathological specimens, provided photographs of these, advised on manuscript descriptions of the pathology found, proofread and approved the manuscript. AC was the consultant responsible for the patient care as an inpatient, advised on and approved the manuscript and communicated with the patient to obtain a signed consent form. MK supervised the development of the manuscript, advised on literature search and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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