Bilateral perirenal hematoma simulating metastasis

Perirenal hematoma is a common complication of traumatism and renal procedures such as nephrostomy, angiography, and lithotripsy. It may constitute a challenging diagnosis in a pre-existing tumor context or in case of an atypical imaging appearance. We present a female patient followed for cervix cancer, who developed bilateral perirenal hematoma with an atypical MRI appearance evoking a malignant tumor. The diagnosis is established by the association of different imaging data (MRI with diffusion and ADC, CT scan without contrast, and CT scan after injection of contrast product). Percutaneous drainage remains the best management option for the perirenal hematoma in hemodynamic stable patients.