title: BCGosis: case report of intravesicular bacille Calmette-Guérin causing upper tract granulomas simulating a renal mass without evidence of ipsilateral vesicoureteral reflux.
abstract: Very rarely, dissemination of intravesical bacille Calmette-Guérin for superficial bladder cancer treatment can lead to a complication in the upper urinary tract. Two mechanisms for dissemination have been proposed: vesicoureteral reflux and hematogenous spread. We report a case of "BCGosis" with the clinical appearance of multifocal renal masses in a patient without ipsilateral reflux. This case highlights the importance of obtaining a renal biopsy in all patients previously treated with bacille Calmette-Guérin presenting with a renal mass. Furthermore, the findings from the present case suggest that vesicoureteral reflux might not be the only mechanism responsible for dissemination of bacille Calmette-Guérin to the upper urinary tract.
authors.affiliation: Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Gita N
authors.initials: GN
authors.lastname: Mody
authors.forename: Veronique
authors.initials: V
authors.lastname: Tran
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006099:Granuloma / Q000139:chemically induced* / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000209:etiology; D007680:Kidney Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D014515:Ureteral Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000209:etiology; D014516:Ureteral Neoplasms / Q000175:diagnosis; D014718:Vesico-Ureteral Reflux
chemical_list: D001500:BCG Vaccine