Hematoma subepitelial de la pelvis renal como causa de defecto de repleción en el estudio radiológico del tracto urinario superior

Abstract

After taking care of a patient with suspicion of upper urinary tract neoplasia which was finally diagnosed of renal pelvis subepithelial hematoma (Antopol-Goldman lesion), we decided to review such unfrequent pathology with the aim to summarize its main characteristics. The patient presented clinically and radiologically as an upper urinary tract tumor and underwent nephroureterectomy. Past history was significant for oral anticoagulative treatment after deep vein thrombosis. Pathologic study of the nephrectomy specimen reported absence of urothelial tumor and presence of a subepithelial hematoma of the renal pelvis, which explained both clinical manifestations and radiological findings. Our case is very similar to the other 27 published in the bibliography. Subepithelial hematoma of the renal pelvis is a benign lesion, more frequent in females, which appears between the fourth and sixth decades of life. Not much is known about its etiopathogenesis, it probably is a multifactorial process. It simulates an upper urinary tract urothelial tumor, both clinically and radiologically, and so is treated in most published cases. It is necessary to know this entity as possible differential diagnosis of upper urinary tract radiological study filling defects to avoid non necessary nephrectomies.