Subscribe to RSS
DOI: 10.1055/s-0031-1271811
© Georg Thieme Verlag KG Stuttgart · New York
Bilateral Focal Xanthogranulomatous Pyelonephritis in a Child Presenting as Complex Cystic Renal Mass: A Report on Non-surgical Treatment
Publication History
Publication Date:
08 April 2011 (online)
Introduction
Xanthogranulomatous pyelonephritis (XGPN) is a distinct, severe, atypical and chronic renal parenchymal infection. It is encountered predominantly in middle-aged women and is relatively rare in childhood [1]. XGPN occurs predominantly unilaterally, and bilateral disease is extremely rare [2] [3] [4] [5] [6]. It may present either as diffuse or, less commonly, as a focal infection. This uncommon condition is characterized by invasion to surrounding structures. Its resemblance to tumoral features presents a diagnostic and therapeutic challenge. Nephrectomy is usually indicated for unilateral XGPN, and the prognosis is excellent if treated early [1]. However, the management of XGPN is difficult due to the risk of permanent renal dysfunction. We report a rare case of bilateral focal XGPN in a child presenting with a complex renal mass managed non-surgically.
References
- 1 Bingöl-Koloğlu M, Ciftçi AO, Senocak ME. et al . Xanthogranulomatous pyelonephritis in children: diagnostic and therapeutic aspects. Eur J Pediatr Surg. 2002; 12 42-48
- 2 Suzer O, Baltaci S, Kuzu I. et al . Bilateral xanthogranulomatous pyelonephritis in a child. Br J Urol. 1996; 78 950-951
- 3 Hyla-Klekot L, Paradysz A, Kucharska G. et al . Successfully treated bilateral xanthogranulomatous pyelonephritis in a child. Pediatr Nephrol. 2008; 23 1895-1896
- 4 Peréz LM, Thrasher JB, Anderson EE. Successful management of bilateral xanthogranulomatous pyelonephritis by bilateral partial nephrectomy. J Urol. 1993; 149 100-102
- 5 Ozcan H, Akyar S, Atasoy C. An unusual manifestation of xanthogranulomatous pyelonephritis: bilateral focal solid renal masses. AJR Am J Roentgenol. 1995; 165 1552-1553
- 6 Karadeniz C, Oguz A, Ataoglu O. et al . Primary renal lymphoma and xanthogranulomatous pyelonephritis in childhood. Nephrol. 2002; 15 597-600
- 7 Youngson GG, Gray ES. Neonatal xanthogranulomatous pyelonephritis. Br J Urol. 1990; 65 541-542
- 8 Eastham J, Ahlering T, Skinner E. Xanthogranulomatous pyelonephritis: clinical findings and surgical considerations. Urology. 1994; 43 295-299
- 9 Loffroy R, Guiu B, Watfa J. et al . Xanthogranulomatous pyelonephritis in adults: clinical and radiological findings in diffuse and focal forms. Clin Radiol. 2007; 62 884-890
- 10 Raziel A, Steinberg R, Kornreich L. et al . Xanthogranulomatous pyelonephritis mimicking malignant disease: Is preservation of the kidney possible?. Pediatr Surg Int. 1997; 12 535-537
- 11 Bercowsky E, Shalhav AL, Portis A. et al . Is the laparoscopic approach justified in patients with xanthogranulomatous pyelonephritis?. Urology. 1999; 54 437-443
- 12 Rodó J, Martin ME, Salarich J. Xanthogranulomatous pyelonephritis in children: conservative management. Eur Urol. 1996; 30 498-501
- 13 Brown Jr PS, Dodson M, Weintrub PS. Xanthogranulomatous pyelonephritis: report of nonsurgical management of a case and review of the literature. Clin Infect Dis. 1996; 22 308-314
- 14 Hughes PM, Gupta SC, Thomas NB. Xanthogranulomatous pyelonephritis in childhood. Clin Radiol. 1990; 41 360-362
- 15 Reul O, Waltregny D, Boverie J. Pseudotumoral xanthogranulomatous pyelonephritis: diagnosis with percutaneous biopsy and success of conservative treatment. Prog Urol. 2001; 11 1274-1276
Correspondence
Dr. Pranjal Modi
Institute of Kidney Disease and Research Centre
Institute of Transplantation Sciences
Department of Urology and Transplantation
Surgery
Civil Hospital Campus
380016 Ahmedabad
India
Phone: +91 792 2685 600
Fax: +91 792 2685 454
Email: dr_pranjal@yahoo.com