Chronic pyonephrosis associated with renal neovascularisation.
The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the radiological findings may suggest a malignancy. To report a case of chronic pyonephrosis, which even at exploration appeared to be a malignancy. The case record of the patient as well as the literature were reviewed and reported. A 25 year-old woman presented with a 5-year history of left lumbar pain, urinary frequency and intermittent total haematuria. The intravenous urography showed non-function in the left kidney harbouring a calculus. Treatment was delayed for poor finances. At laparotomy a huge renal mass invading the colonic mesentery and showing neovascularisation was removed. The final diagnosis was chronic pyonephrosis. She recovered from postoperative septicaemia. Neovascularisation is a feature of malignant disease mediated by angiogenesis factors. These factors are probably present in chronic inflammation. It is suggested that for nephrectomy, prophylactic antibiotics should be used. There is also a need for histopathological examination of every specimen removed at operation.
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Urology Unit, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
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D000328:Adult; D001416:Back Pain / Q000209:etiology; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000382:microbiology; D007710:Klebsiella Infections / Q000175:diagnosis; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D011704:Pyelonephritis / Q000175:diagnosis* / Q000382:microbiology; D014555:Urination Disorders / Q000209:etiology