Xanthogranulomatous Pyelonephritis with Pancreatic Infiltration: A Rare Case Report

Authors

  • Ahmed Chaabouni Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author
  • Hazem Hachicha Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author
  • Mohamed Fourati Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author
  • Mourad Hadj Slimen Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author
  • Houcem Harbi General Surgery Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author
  • Basma Soussi Radiology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author
  • Nozha Toumi Radiology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia Author

DOI:

https://doi.org/10.47363/JIDSCR/2025(6)201

Keywords:

Xanthogranulomatous, pyelonephritis

Abstract

Introduction: Xanthogranulomatous pyelonephritis (XGP) is a rare chronic granulomatous infection of the kidney usually linked to urinary tract obstruction and infection. Extension into adjacent organs is uncommon pancreatic involvement is exceptionally rare.

Case Presentation : A 45-year-old woman with recurrent left renal colic presented with pyelonephritis and left-sided pain. Laboratory tests showed leukocytosis and elevated C-reactive protein with preserved renal function. CT revealed an enlarged left kidney with staghorn calculi and a “bear paw” appearance adherent to a lesion of the pancreatic tail. MRI confirmed an infiltrative process. After intravenous antibiotics, en bloc left nephrectomy with splenopancreatectomy was performed. Histopathology confirmed XGP extending into the pancreatic tail. Recovery was uneventful, with spontaneous closure of a low-output pancreatic fistula and no recurrence at 6-month follow-up.

Conclusion: Pancreatic infiltration by XGP is extremely rare and can mimic renal or retroperitoneal malignancy. Recognition of characteristic imaging features and histopathological confirmation are crucial for accurate diagnosis and appropriate surgical management.

Author Biographies

  • Ahmed Chaabouni, Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

  • Hazem Hachicha, Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

  • Mohamed Fourati, Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

  • Mourad Hadj Slimen, Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    Urology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

  • Houcem Harbi, General Surgery Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    General Surgery Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

  • Basma Soussi, Radiology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    Radiology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

  • Nozha Toumi, Radiology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

    Radiology Department - Habib Bourguiba Hospital – University of Sfax, Tunisia

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Published

2025-10-29

Issue

Vol. 6 No. 4 (2025): Volume 6, Issue 4

Section

Articles