Uncommon Presentation of Isolated Renal Tuberculosis with a Distinct Infectious-Inflammatory-Neoplastic Triad

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Isolated renal tuberculosis is a rare extrapulmonary manifestation that often mimics urinary tract infections, leading to delayed diagnosis.
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A 77-year-old diabetic man presented with left loin pain and chronic lumbar sinus discharge, revealing complex renal pathologies.
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Multiphase CT showed renal replacement lipomatosis, a hyperenhancing mass suggestive of clear cell renal cell carcinoma, and signs of renal tuberculosis.
4

Radical nephrectomy confirmed renal tuberculosis and its complications, including a perinephric abscess and nephrocutaneous fistula.
5

Postoperative antitubercular therapy resulted in stable clinical outcomes, highlighting the importance of early imaging and diagnosis.

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