Xanthogranulomatous cystitis in a child

Xanthogranulomatous cystitis masquerading as bladder tumor in a child

“…The etiology of XGC remains unclear – chronic infection and inflammation with associated urachal remnant, immunological mechanisms, foreign body reaction, reaction to a local tumor, and abnormal lipid metabolism have been proposed. [ 1 4 5 ] Chronic Gram-negative UTI was in evidence here; no neoplasia was identifiable at histopathology. Like others,[ 3 ] we noted imaging findings of heterogeneous mass lesions with hypoechoic/hypodense areas.…”

“…Thirty cases of XGC have been reported in the published English literature. [ 1 ] Most (85%) were adults and only two pediatric cases are documented. [ 1 4 ] The median age of presentation was 45 years without predilection for either sex.…”

“…[ 1 ] Most (85%) were adults and only two pediatric cases are documented. [ 1 4 ] The median age of presentation was 45 years without predilection for either sex. Most were located on the dome of the urinary bladder (85%) and associated with a urachal remnant (70%).…”

“…Although benign, management options adopted for XGC have ranged from simple excision to partial or even radical cystectomy. [ 1 4 5 ] Medical management with antibiotics has been used as a postoperative adjunct earlier. In this case, the clinicoradiological resolution with antibiotics (intravenous for 2 weeks and oral for 2 weeks) alone suggests that the process was probably in the early stages following a chronic UTI.…”

“…Xanthogranulomatous cystitis (XGC) affecting the urinary bladder is extremely rare, and only around thirty adult cases and two pediatric cases have been reported in the literature so far. [ 1 ] Conventionally, the treatment is surgical as the lesion is mostly infiltrative and mimics malignancy. We report the third pediatric case, who was initially suspected as bladder tumor, but he responded well to aggressive antibiotic therapy alone.…”