A Rare Case of Unilateral Xanthogranulomatous Ureteritis Mimicking an Inferior Vena Cava Tumor

Abstract

Xanthogranulomatous pyelonephritis (XPG) is a known clinical entity; however, the further progression of this inflammatory pathology to adjacent organs, including the ureter, bladder and urethra, is extremely rare. Xanthogranulomatous inflammation of the ureter is a chronic inflammatory state where foamy macrophages are seen in the lamina propria along with multinucleated giant cells and lymphocytes forming a granulomatous inflammation, which is benign. Based on its appearance on computed tomography (CT) scan images, it can easily be misidentified as a malignant mass, and the patient can be subjected to surgery that can lead to complications. Here we present a case of an elderly male with a known case of chronic kidney disease with uncontrolled type 2 diabetes mellitus who presented with fever and dysuria. Upon further radiological investigations, the patient had underlying sepsis and was seen to have a mass involving the right ureter and inferior vena cava. Upon biopsy and histopathology, he was diagnosed with xanthogranulomatous ureteritis (XGU). The patient underwent further treatment and was followed up.

A Rare Case of Xanthogranulomatous Cystitis Mimicking Bladder Malignancy in Nigeria: A Case Report and Review of Literature

“…Although xanthogranulomatous inflammatory changes occur commonly in other sites, such as kidneys, gall bladder, salivary glands, ovaries, endometrium, pancreas, brain, colon, and appendix, there are very few reported cases in the urinary bladder [ 2 , 4 ]. In the urinary tract, xanthogranulomatous pyelonephritis is commonly encountered; however, involvement of the ureters, bladder, and urethra by xanthogranulomatous inflammation is an extreme rarity [ 5 ].…”