A rare but misleading cause of hematuria in hemophilia A: renal pelvic hemorrhage mimicking tumor.
Emine Turkkan, Ozge Yapici, Demet Alaygut
✦ AI-curated · Sources linked
Case in brief
A patient with severe hemophilia A presented with gross hematuria. Imaging showed a renal pelvic lesion that initially suggested a urothelial tumor. In the context of hemophilia, the imaging characteristics and response to factor VIII replacement supported spontaneous renal pelvic hemorrhage, known as an Antopol-Goldman lesion, rather than a tumor.
What made this case unusual
The renal pelvic hemorrhage produced imaging findings that mimicked a urothelial tumor, creating a diagnostic pitfall in a patient with a bleeding disorder.
Diagnostic / clinical pearl
In hemophilia A with gross hematuria and atypical upper-tract imaging, consider renal pelvic hemorrhage and interpret imaging alongside the clinical context and response to factor VIII replacement.
Why it matters
Recognizing a benign hemorrhagic cause may help avoid unnecessary invasive procedures.