Antopol-Goldman lesion: a rare clinical entity in the differential diagnosis of macroscopic hematuria.

OBJECTIVE: To describe the case of a patient with gross hematuria. The pathological study revealed a subepithelial hematoma of the renal pelvis (Antopol-Goldman lesion). METHODS/RESULTS: An 86 year-old woman presented with gross hematuria through the right ureteral orifice. A filling defect is visualized in the right renal pelvis on CT and right nephroureterectomy was carried out after the diagnosis of suspicious upper urinary tract tumor. The pathological study revealed the presence of a subepithelial hematoma without evidence of malignancy. CONCLUSION: Antopol-Goldman lesion is a benign condition that one must have in mind in the work up of patients with hematuria and filling defects in the urinary tract who present a predisposing factor for pyelic hematoma.

Lesión de Antopol-Goldman: un cuadro raro en el diagnóstico diferencia de la hematuria macroscópica / Antopol-goldman lesion: a rare clinical entity in the differential diagnosis of macroscopic hematuria

OBJETIVO: Describir el caso clínico de una paciente que presenta hematuria macroscópica y que el estudio anatomopatológico revela un hematoma subepitelial de la pelvis renal (lesión de Antopol-Goldman). MÉTODOS: Se describe el caso clínico de un paciente con hematuria macroscópica que tras nefrectomía radical es diagnosticado de hematoma subepitelial (lesión de Antopol-Goldman) y se realiza una revisión bibliográfica del diagnóstico y tratamiento de esta lesión. RESULTADOS: Paciente que tras presentar hematuria macroscópica a través de meato ureteral derecho con defecto de replección en pelvis renal derecha visualizado en TAC es diagnosticada de tumor de tracto urinario superior y tratada mediante nefroureterectomía derecha. El estudio anatomopatológico revela la presencia de un hematoma subepitelial sin evidencia de malignidad. CONCLUSIÓN: La lesión de Antopol-Goldman es una patología benigna que hay que tener presente en pacientes con hematuria y defectos de replección en la vía urinaria que presenten algún factor predisponente para la aparición de hematomas piélicos(AU)

OBJECTIVE: To describe the case of a patient with gross hematuria. The pathological study revealed a subepithelial hematoma of the renal pelvis (Antopol-Goldman lesion). METHODS/RESULTS: An 86 year-old woman presented with gross hematuria through the right ureteral orifice. A filling defect is visualized in the right renal pelvis on CT and right nephroureterectomy was carried out after the diagnosis of suspicious upper urinary tract tumor. The pathological study revealed the presence of a subepithelial hematoma without evidence of malignancy. CONCLUSION: Antopol-Goldman lesion is a benign condition that one must have in mind in the work up of patients with hematuria and filling defects in the urinary tract who present a predisposing factor for pyelic hematoma(AU)

Benign calcifying fibrous-myofibroblastic tumor mimicking myositis ossificans in a 22-month-old girl.

Myositis ossificans circumscripta (MOC), with nonneoplastic heterotopic bone formation in soft tissue and skeletal muscle, is rare in children. Extraskeletal osteosarcoma is a very rare malignant mesenchymal neoplasm of soft tissues in children. At onset, it may be difficult to distinguish MOC from a musculoskeletal infection or neoplasm, particularly in the absence of trauma, and a biopsy is frequently required. However, differentiating MOC from malignant neoplasm is imperative. We describe the case of a 22-month-old girl who presented with a benign fibrous-myofibroblastic tumor mimicking MOC. However, extraskeletal osteosarcoma was also considered in the differential diagnosis due to the absence of attachment of the lesion to the skeleton. Pathologic findings after a previous needle biopsy and posterior marginal resection exclude both differential diagnoses. Close follow-up during 3 years postoperatively showed no signs of recurrence.

Leiomioma cotiledonoide disecante del útero. A propósito de dos casos y revisión de la literatura / Cotyledonoid dissecting leiomyoma of the uterus. Report of two cases and review of the literature

Introducción: El leiomioma cotiledonoide disecante del útero o tumor de Sternberg es un tumor benigno de músculo liso caracterizado por tener un patrón de crecimiento inusual. Pacientes y métodos: Presentamos los hallazgos histopatológicos de dos casos (pacientes de 41 y 56 años) de esta rara variante de leiomioma uterino. Inmunohistoquímicamente se confirmó la naturaleza muscular lisa de las lesiones. Resultados: En ambas pacientes se observó una gran masa polilobulada dependiente del útero que ocupaba la pelvis. Se realizó histerectomía y doble anexectomía con exéresis de masas pélvicas. En el estudio anátomopatológico se observaron múltiples masas bulbosas de aspecto alarmante compuestas por haces de músculo liso que se extendían por la superficie externa del útero y se continuaban con un componente intramiometrial que disecaba la pared uterina. No se encontraron atipia nuclear significativa, mitosis ni necrosis. Conclusiones: A pesar de su aspecto alarmante estos tumores, su comportamiento es benigno, por lo que hacemos hincapié en la importancia de su adecuado diagnóstico. Es muy aconsejable la realización de un estudio microscopico intraoperatorio para realizar un adecuado tratamiento de las pacientes (AU)

Introduction: Cotyledonoid dissecting leiomyoma or Sternberg tumor is a benign smooth muscle tumor with an unusual growth pattern. Patients and methods: Histopathological findings of two cases (41 and 56 year old females) of this rare variant of uterine leiomyoma are analyzed. Results: In both cases several nodules conforming an uterus-depending great mass occupying the pelvis were found. Total hysterectomy, bilateral salpingo-oophorectomy and pelvic masses removal were performed. On microscopic examination, several bulbous masses with alarming appearance were found. Masses were formed by bundles of smooth muscle cells extending over the external uterine surface and continuing with an intramyometrial tumoral component dissecting the uterine wall. Significant nuclear atypia, mitoses and necrosis were absent. Conclusions: In spite of the alarming aspect of these lesions, their evolution is benign in most cases. The importance of delivering a precise pathological diagnosis will prevent an inadequate treatment of the patients. An intraoperative pathological examination is recommended (AU)