title: Xantogranulomatous pyelonephritis: The missed diagnosis.
abstract: BACKGROUND
  Xantogranulomatous pyelonephritis (XGPN) is a rare chronic inflammatory disease of the kidney that can be focal or diffuse with the focal form imitating greatly renal cell carcinoma (RCC).
  
  
  METHODS
  We report a challenging clinical case of a 38-year old male with right flank pain persisting for 3-months, imaging showed an 8cm heterogenous mass of the upper pole of the right kidney and invading the liver. A right radical nephrectomy including the adrenal in the resection was performed under the tentative diagnosis of renal cell carcinoma (RCC) whereas histology revealed focal XGPN.
  
  
  CONCLUSIONS
  Preoperative diagnosis of focal XGPN was difficult because of radiological similarities to RCC and lack of history of stone disease or urinary tract infection.
  
  
  CONCLUSIONS
  This case highlights the need to include XGPN in the differential diagnosis of RCC even in the era of modern imaging.
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco. Electronic address: yassineelabiad@gmail.com.
authors.forename: Yassine
authors.initials: Y
authors.lastname: El Abiad
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco. Electronic address: dr.y.dehayni@gmail.com.
authors.forename: Youness
authors.initials: Y
authors.lastname: Dehayni
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco. Electronic address: abdelmounaimqarro@yahoo.fr.
authors.forename: Abdelmounaim
authors.initials: A
authors.lastname: Qarro
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco. Electronic address: bbouziduro@hotmail.com.
authors.forename: Bouzid
authors.initials: B
authors.lastname: Balla
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco. Electronic address: ammani-1@hotmail.com.
authors.forename: Abdelghani
authors.initials: A
authors.lastname: Ammani
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknès, Morocco. Electronic address: alami.mohammed1@yahoo.fr.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alami
keywords: Diagnostic imaging; Infection; Renal cell carcinoma; Tumor; Xantogranulomatous pyelonaphritis