Xanthogranulomatous Glomerulonephritis Mimicking Malignancy in a Two-Year-Old Child: A Case Report

Xanthogranulomatous glomerulonephritis/pyelonephritis is an uncommon inflammatory condition in children and can present as a renal mass, closely mimicking malignant tumors on imaging. We report a two-year-old girl who presented with abdominal distension and severe anemia. Ultrasound, computed tomography (CT), and magnetic resonance imaging demonstrated an enlarged, non-functioning left kidney with necrotic-appearing areas and diffusion restriction, raising suspicion for malignancy. Because imaging could not exclude a tumor and the mass persisted despite antibiotics, nephrectomy with lymph node sampling was performed. Histopathology confirmed xanthogranulomatous inflammation and excluded malignancy. This case underscores the diagnostic challenge and the importance of timely surgical and histopathological confirmation when pediatric renal masses mimic cancer.