We present a case of Xanthogranulomatous pyelonephritis mimicking as a renal cell carcinoma. This was an elderly lady who presented with pyonephrosis due to urolithiasis. On evaluation she was found to have a space occupying mass in the right kidney. Further investigations revealed an enhancing tumor with renal vein thrombus and paracaval lymphadenopathy. Subsequent histopathology showed evidence of XGPN with no malignancy. This case report highlights the fact there are a number of imaging and clinical overlaps in the diagnosis, assessment and management of this entity.
