案例報告：罕見泌尿道疾病–黃色肉芽腫性炎症

李昀叡¹、余家政¹、王大齊¹

高雄榮總外科部泌尿外科¹

Case report: A rare urological disease – Xanthogranulomatous inflammation

Yun-Jui Li¹, Chia-Cheng Yu¹, Ta-Chi Wang¹

¹Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

Introduction:

Xanthogranulomatous inflammation is rare chronic inflammatory disorder characterized by the accumulation of lipid-filled foamy macrophages, also known as xanthoma cells. Although its exact cause remains unclear, several contributing mechanisms have been suggested, including recurrent or persistent infection, gallstone-related irritation, immunologic abnormalities, and defects in lipid metabolism or transport. In rare cases, xanthogranulomatous inflammation may occur alongside an underlying malignancy. Clinically and radiologically, it can present as a mass-forming inflammatory lesion that invades adjacent tissues, closely resembling advanced cancer. As a result, surgical intervention combined with thorough pathological examination is essential to achieve an accurate diagnosis.

Case Report:

This is a 56-year-old female with underlying disease of hypertension. According to the patient, she had right cellulitis over inguinal area s/p pigtail drainage on 11/28 in another hospital (admitted from 11/20) and AAD on 12/4. Due to persisting swelling and pain over right thigh, the patient came to our ER for help. At triage, her lab data showed CRP 15.3, PCT＜0.1, WBC 11.04, Hb 8.8, INR 1.37. U/A was in normal limits. U/C and B/C were pending. Extremity CTA has underwent and pending for reports. Under the impression of 1. Right inguinal cellulitis s/p partial treat. 2. Mass lesion along right iliopsoas muscle, etiology known. The patient was admitted for further survey and evaluation.

Conclusion:

It is important for both surgeons and pathologists to recognize xanthogranulomatous inflammatory lesions, as they can closely resemble malignant tumors and may lead to overly aggressive surgical treatment. In clinical, the lesion often mimics as malignancy and confirmatory diagnosis is made on histopathology. For this reason, all removed specimens must be carefully examined under the microscope to confirm the diagnosis and exclude other possible conditions.