A Rare Case of Multifocal Xanthogranulomatous Disease Involving the Entire Urinary Tract: Diagnosis and Management Challenges

Background: Xanthogranuloma is a granulomatous lesion caused by a bacterial infection, usually found in the lungs, skin, and digestive system. Xanthogranulomas in the urinary system are relatively rare, and cases of total urinary tract involvement are even rarer. Case presentation: This report presents a case of total urinary xanthogranuloma in a 67-year-old woman with long-term hypertension and diabetes, presenting with multiple urinary tract infections and renal failure, who was initially misdiagnosed as metastatic malignancy by PET-CT imaging. The final diagnosis was a total urinary xanthogranuloma. Conclusions: This paper reviews the diagnostic process, treatment methods, and prognosis of this patient, and discusses the underlying pathophysiological mechanisms between diabetes-related immunosuppression and disease progression. To provide a reference for the clinical diagnosis and treatment of similar diseases in the future.