Robotic Heminephrectomy for Xanthogranulomatous Pyelonephritis in a Pediatric Patient

species, an organism commonly associated with XGP. Despite intravenous antibiotic therapy and drainage, repeat imaging demonstrated persistent lesion size and inflammatory burden. Given ongoing concern for a non-resolving renal mass, the patient underwent robotic-assisted left upper pole heminephrectomy. Intraoperatively, the upper pole was grossly abnormal with no viable renal parenchyma and a large abscess cavity. Final histopathologic evaluation confirmed focal XGP. Although rare in children, XGP should remain on the differential diagnosis for complex renal masses, particularly when imaging demonstrates inflammatory or abscess-like features. This case highlights the diagnostic challenge of pediatric focal XGP and demonstrates the feasibility of a robotic-assisted nephron-sparing heminephrectomy approach in carefully selected patients. Early recognition of this entity may help guide timely surgical intervention while avoiding overtreatment for presumed malignancy and preserving functional renal tissue whenever possible.