Abstract
Background: Xanthogranulomatous pyelonephritis (XGP) is a rare renal tumor that arises as a complication of chronic
obstructive pyelonephritis of uncertain etiology. It is primarily an adult tumor seen occasionally in children associated with
urinary tract obstruction due to congenital urological anomalies, nephrolithiasis, and recurrent urinary tract infections.
Radiologically, it may show neoplastic features such as those seen in common pediatric renal malignancies like wilms’
tumor and renal cell carcinoma. This overlap in radiological manifestation frequently leads to misdiagnosis and delay in
appropriate intervention. We report a case of a 3 years old boy who presented with history of recurrent urinary tract
infections and a left renal mass initially thought to be Wilms’ tumor.
Case presentation: We present a case of a 3 years old boy admitted to the Pediatric oncology unit at Muhimbli National
Hospital in Dar es Salaam, Tanzania with one year history of recurrent fever and urinary tract infection signs and
symptoms refractory to antibiotic therapy. He was eventually found to have a left kidney mass detected at the District
hospital by abdominal ultrasound performed to evaluate a flank mass that was felt by his mother. He was then referred
to our unit for a suspicion of Wilms’ tumor which finally turned out to be a left kidney Xanthogranulomatous
pyelonephritis.
He underwent a successful left nephrectomy and was discharged from hospital in a stable clinical condition and remains
asymptomatic at the time of submission of this case report.
Conclusion: This case report underscores the need for clinicians attending a febrile child with a renal mass
that can be confused with common pediatric renal malignancies such as Wilms’ tumor to broaden their
differential diagnosis. The case also underlines the significance of individualized patient evaluation because
this patient would have otherwise received preoperative chemotherapy under the International Society of
Pediatric Oncology (SIOP) guidelines if the diagnosis of Wilms tumor was not ruled out.
Iumanne, S (2021). Case report: Xanthogranulomutous pyelonephritis presenting as “Wilms’ tumor”. Afribary. Retrieved from https://tracking.afribary.com/works/case-report-xanthogranulomutous-pyelonephritis-presenting-as-wilms-tumor
Iumanne, Shakilu "Case report: Xanthogranulomutous pyelonephritis presenting as “Wilms’ tumor”" Afribary. Afribary, 25 Apr. 2021, https://tracking.afribary.com/works/case-report-xanthogranulomutous-pyelonephritis-presenting-as-wilms-tumor. Accessed 09 Nov. 2024.
Iumanne, Shakilu . "Case report: Xanthogranulomutous pyelonephritis presenting as “Wilms’ tumor”". Afribary, Afribary, 25 Apr. 2021. Web. 09 Nov. 2024. < https://tracking.afribary.com/works/case-report-xanthogranulomutous-pyelonephritis-presenting-as-wilms-tumor >.
Iumanne, Shakilu . "Case report: Xanthogranulomutous pyelonephritis presenting as “Wilms’ tumor”" Afribary (2021). Accessed November 09, 2024. https://tracking.afribary.com/works/case-report-xanthogranulomutous-pyelonephritis-presenting-as-wilms-tumor