Renal malakoplakia with invasion of the liver and diaphragm: a patient case and literature review
BMJ Case Reports, 2022
Joel Grunhut, Ricardo Oroz, Shimron Brown, Roozbeh Nazarian-Rostami
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In brief
Renal malakoplakia is a rare chronic inflammatory condition that can look like kidney cancer on imaging. We describe a 59-year-old woman whose renal mass invaded the liver and diaphragm, a pattern not previously reported in the literature, and who was correctly diagnosed only on pathology.
Key findings
Our literature review found no prior reports of renal malakoplakia invading the liver and diaphragm.
Malakoplakia mimics other renal masses clinically and radiologically and ultimately requires a pathological diagnosis.
Waiting for biopsy and pathology before surgery is critical to avoid unnecessary kidney surgery.
Abstract
Renal malakoplakia, a seldom seen chronic inflammatory condition, continues to elude medical, surgical, radiological and pathological specialists due to its mimicry of other renal pathologies and low incidence. The variable clinical manifestations and non-specific radiological findings of malakoplakia can be misleading, and ultimately require a pathological diagnosis. A literature review reveals an extremely low prevalence of renal malakoplakia, a handful of invasive renal malakoplakia cases and no reports of liver and diaphragmatic invasion. We present a case of a renal mass with liver and diaphragmatic invasion in a 59-year-old woman that deceived clinicians and radiologists until a pathological diagnosis of renal malakoplakia was performed. This case highlights the need of awareness for malakoplakia in the differential diagnosis for renal invasive and non-invasive masses. The need to await a surgical biopsy and pathological diagnosis is critical to ensure a correct diagnosis and avoid unnecessary surgery of the kidney.
How to cite
Grunhut J, Oroz R, Brown S, Nazarian-Rostami R. Renal malakoplakia with invasion of the liver and diaphragm: a patient case and literature review. BMJ Case Rep. 2022;15(9). doi:10.1136/bcr-2022-251254