title: Xanthogranulomatous pyelonephritis presenting as a pseudotumour.
abstract: BACKGROUND
  Xanthogranulomatous pyelonephritis (XGPN) is an atypical form of chronic pyelonephritis referred to as the "great imitator" because the clinical and radiological findings closely resemble other pathological entities, especially for the focal forms. Distinguishing focal XGPN from renal cancer is preoperatively difficult.
  
  
  METHODS
  We report a total number of 12 pseudotumoural XGPN cases diagnosed and treated in our department. The aim of this study is to try to better understand the clinicopathological profile of XGPN and improve its management.
  
  
  RESULTS
  The mean age of patients was 51.52 years. Gender ratio was 0.71. An obstructive renal calculus was noticed in nine patients (75%). Only one patient (8.3 %) presented with loin pain associated with fever, weight loss, asthenia, and increased biological inflammation markers. A bifocal mass was noticed in one case (8.3 %). The average size of the tumour was 6.58 cm. The mass was cystic in three cases (25 %). Perinephral fat strand, thickening of Gerota's fascia, hydronephrosis, and presence of renal calculi was noticed in all solid tumour cases. XGPN was suspected in only one case (8.3%), a percutaneous biopsy showed XGPN lesions treated by antibiotics and a double J drainage. Radical nephrectomy was performed in eight patients (66.7 %) and three patients underwent partial nephrectomy (25 %). No recurrence of XGPN has been noted.
  
  
  CONCLUSIONS
  Pseudotumoural XGPN is a rare benign disease of the kidney. Its treatment should be conservative. Lack of knowledge of this disease may explain the high rate of abusive nephrectomies. These data should be considered in the future.
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Mohamed
authors: M
authors: Chlif
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Marouene
authors: M
authors: Chakroun
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Sami
authors: S
authors: Ben Rhouma
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Mohamed Ali
authors: MA
authors: Ben Chehida
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Ahmed
authors: A
authors: Sellami
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Mohamed Mourad
authors: MM
authors: Gargouri
authors: Urology Department, La Rabta Hospital, Tunis, Tunisia.
authors: Yassine
authors: Y
authors: Nouira