{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:03:34Z","timestamp":1784289814374,"version":"3.55.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Isolated renal tuberculosis (RTB) is a rare extrapulmonary manifestation of tuberculosis that often mimics common urinary tract infections, resulting in delayed diagnosis and complications. We report an exceptionally rare case of isolated RTB presenting with a spectrum of destructive sequelae\u2014including a perinephric abscess with a nephrocutaneous fistula, renal replacement lipomatosis (RRL), and synchronous clear cell renal cell carcinoma (RCC) within a single kidney. We report the case of a 77-year-old diabetic man who presented with left loin pain and chronic lumbar sinus discharge. Multiphase computed tomography (CT) revealed an enlarged, distorted kidney with extensive sinus and perinephric fat proliferation consistent with RRL; a hyperenhancing superior-pole mass suggestive of RCC; calyceal distortion and infundibular stenosis suspicious for RTB; and a perinephric abscess with a cutaneous fistula. Radical nephrectomy was performed, and histopathological examination confirmed renal tuberculosis and its associated complications. Subsequent antitubercular therapy (ATT) resulted in stable clinical and functional outcomes. To the best of our knowledge, this is the first reported case demonstrating this constellation of infectious\u2013inflammatory\u2013neoplastic pathologies within a single kidney. This case highlights the indolent yet destructive nature of isolated RTB and emphasizes the role of early imaging and histopathology for timely diagnosis, prevention of serious complications, and an improved prognosis.<\/jats:p>","DOI":"10.3389\/fmed.2026.1777156","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:10:11Z","timestamp":1784286611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid eclipse: a case of isolated renal tuberculosis with an unusual infectious\u2013inflammatory\u2013neoplastic triad"],"prefix":"10.3389","volume":"13","author":[{"given":"Sachin","family":"Dharwadkar","sequence":"first","affiliation":[{"name":"Department of Urology, JSS Medical College, JSSAHER","place":["Mysuru, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaykumar","family":"Ramu","sequence":"additional","affiliation":[{"name":"Department of Urology, JSS Medical College, JSSAHER","place":["Mysuru, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavitha B.","family":"Chittaragi","sequence":"additional","affiliation":[{"name":"Department of Radiology, JSS Medical College, JSSAHER","place":["Mysuru, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitha","family":"Sathish","sequence":"additional","affiliation":[{"name":"Department of Pathology, JSS Medical College, JSSAHER","place":["Mysuru, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha Kiran","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Radiology, JSS Medical College, JSSAHER","place":["Mysuru, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajan","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Department of Urology, JSS Medical College, JSSAHER","place":["Mysuru, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"102876","DOI":"10.1016\/j.eucr.2024.102876","article-title":"Hydronephrosis secondary to isolated renal tuberculosis in an immunocompetent adolescent: \u201ca case report\u201d","volume":"57","author":"Noori","year":"2024","journal-title":"Urol Case Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"54","DOI":"10.4269\/ajtmh.2013.12-0413","article-title":"Renal tuberculosis in the modern era","volume":"88","author":"Daher Ede","year":"2013","journal-title":"Am J Trop Med Hyg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s40134-014-0069-5","article-title":"Multidetector CT in renal tuberculosis","volume":"2","author":"Sankhe","year":"2014","journal-title":"Curr Radiol Rep"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1007\/s11934-008-0053-9","article-title":"An update on lower urinary tract tuberculosis","volume":"9","author":"Wise","year":"2008","journal-title":"Curr Urol Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"356","DOI":"10.4103\/0970-1591.42618","article-title":"Incidence, etiopathogenesis and pathological aspects of genitourinary tuberculosis in India: a journey revisited","volume":"24","author":"Das","year":"2008","journal-title":"Indian J Urol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"5311","DOI":"10.1097\/MS9.0000000000003576","article-title":"Isolated renal tuberculosis presenting as staghorn calculi and hydronephrosis - 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