To report a rare case of isolated renal tuberculosis presenting with multiple complications, including renal replacement lipomatosis and synchronous clear cell renal cell carcinoma within a single kidney.
Approach:
Case Report: A 77-year-old diabetic man presented with left loin pain and chronic lumbar sinus discharge. Imaging revealed extensive renal complications, including renal replacement lipomatosis and a suspicious mass for malignancy, leading to radical nephrectomy.
Diagnostic Assessment: Initial tests showed negative results for acid-fast bacilli and no bacterial or fungal growth. Imaging indicated renal replacement lipomatosis and a hyperenhancing mass suggestive of malignancy.
Therapeutic Intervention: A left radical nephrectomy was performed, and histopathological examination confirmed renal tuberculosis and associated complications.
Key Findings:
Isolated renal tuberculosis can present with destructive sequelae, including perinephric abscess and renal replacement lipomatosis.
The case involved synchronous clear cell renal cell carcinoma within the same kidney, confirmed by imaging.
Histopathological examination confirmed the diagnosis of renal tuberculosis post-nephrectomy.
Interpretation:
This case illustrates the coexistence of infectious, inflammatory, and neoplastic processes in isolated renal tuberculosis.
Limitations:
The case is based on a single patient report, limiting generalizability to broader populations.
There is a lack of prior documented cases of this specific combination of pathologies.
Conclusion:
The coexistence of renal tuberculosis with malignancy and other complications is rare.
