Subepithelial pelvic hematoma (Antopol--Goldman lesion) simulating renal neoplasm: report of a case and review of the literature

Int J Surg Pathol. 2009 Jun;17(3):264-7. doi: 10.1177/1066896908330482. Epub 2009 Jan 22.

Abstract

The Antopol-Goldman lesion is a subepithelial pelvic hematoma simulating a renal neoplasm. We report the clinico-pathological features of a single case and a review of the literature. A 76-year-old man presented with flank pain and hematuria. Computed tomography showed a hypodense lesion of 6 cm at the left kidney with filling defect at pyelogram. The patient underwent nephroureterectomy for suspected neoplasm. Macroscopically, a mass of 6 cm was present impinging on the pelvi-caliceal system. Microscopically, the lesion was composed by hemorragic material with feature of an hematoma. A diffuse eosinophilic amorphous material suspicious for amyloid was observed among intra- and extraparenchymal vessels. The Congo-Red staining verified the presence of amyloid. The diagnosis was subepithelial pelvic hematoma with severe amyloidosis. Antopol-Goldman lesion should be kept in mind as a possible differential diagnosis of upper urinary tract lesion to avoid unnecessary nephrectomies. The anamnestic knowledge of amiloydosis may increase this diagnostic hypothesis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Amyloidosis / complications
  • Amyloidosis / pathology
  • Diagnosis, Differential
  • Hematoma / complications
  • Hematoma / pathology*
  • Hematoma / surgery
  • Humans
  • Kidney Neoplasms / pathology*
  • Kidney Pelvis / pathology*
  • Kidney Pelvis / surgery
  • Male
  • Nephrectomy
  • Tomography, X-Ray Computed