Subepithelial pelvic hematoma of the kidney clinically mimicking cancer: report of six cases and review of the literature. Urology 1999 Feb;53(2):276-9
Date
02/05/1999Pubmed ID
9933039DOI
10.1016/s0090-4295(98)00507-xScopus ID
2-s2.0-0032893319 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
OBJECTIVES: Renal pelvic subepithelial hematoma is a rare but significant clinical mimic of neoplasm. Investigation and treatment of this diagnostic problem are uncertain.
METHODS: We add 6 patients with this entity to the 15 previously published cases. All 6 were clinically suspected of having cancer, and 5 underwent nephrectomy.
RESULTS: The most common clinical findings are gross hematuria (19 of 21 cases) and acute onset of flank pain (13 of 21 cases). Intravenous urogram usually reveals a filling defect at the ureteropelvic junction. Pathologic findings include massive subepithelial and peripelvic hemorrhage, hydronephrosis, cortical infarcts, and renomegaly. Two of our patients have previously undescribed clinical associations, including one who was 2 weeks postpartum and another with ureteropelvic junction obstruction. In addition, our patient with obstruction is the first with subepithelial hematoma to be treated successfully with pyeloplasty.
CONCLUSIONS: Subepithelial pelvic hematoma may be effectively treated with pyeloplasty or partial nephrectomy if distinguished from cancer preoperatively. Awareness of this rare entity may allow preoperative identification, but this has not been possible to date.
Author List
Iczkowski KA, Sweat SD, Bostwick DGMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Diagnosis, Differential
Female
Hematoma
Humans
Kidney Diseases
Kidney Neoplasms
Kidney Pelvis
Male
Middle Aged
