Malakoplakia mimicking renal tumor: A case report with literature review

Summary: ABSTRACT Introduction: Malakoplakia is a granulomatous inflammation results from functional defect of macrophages. Renal malakoplakia is uncommon and could be mistaken as malignant tumor. Being aware of this entity is essential in clinical practice. Presentation of case: We reported a case of a middle-aged man having a mass in the left kidney with a past history of persistent urinary tract infection. The mass was discovered incidentally and diagnosed as renal cancer. The histopathological examination revealed malakoplakia. The treatment included antibiotics and fluid drainage from the mass. Discussion: The formation of lesion in malakoplakia is from lysosome impairment leading to insufficient bacteria killing of macrophages. Immunosuppressed people are predisposed to this disease and E. coli is associated in about two third of cases. Unifocal lesion is rare in kidney and might be misdiagnosed as tumor. Histopathological examination has crucial role in definitive diagnosis and exclusion of malignant lesion. Treatment of malakoplakia depends on the number and extent of lesions, including antibiotic therapy or surgical excision. Conclusion: Malakoplakia must be put in differential diagnosis for patients presenting with a renal mass and a history of persistent urinary tract infection.