WEGENERS GRANULOMATOSIS LIMITED TO THE KIDNEY AS A MASS-LIKE LESION

We report on a 45-year-old female who presented with end-stage renal d isease due to Wegener's granulomatosis limited to the kidneys. Ultraso nography and computed tomography revealed a masslike expansion involvi ng the upper pole of an otherwise small right kidney. Histopathology o f a nephrectomy specimen revealed cystic dilatation of renal tubules a nd active lesions of Wegener's granulomatosis in the upper pale. The l ower part of the kidney showed atrophic changes. Wegener's granulomato sis presenting as a renal mass is extremely rare. Only 3 cases have be en previously reported in the literature. Wegener's granulomatosis onl y limited to the kidney is also race. A brief review of 23 previously reported cases who initially presented with renal disease is presented . All but 2 patients subsequently manifested extrarenal lesions. Our p atient continues to be free of any extrarenal involvement 18 months fo llowing presentation, although subsequent development of extrarenal le sions cannot be ruled out.