[Retroperitoneal hematoma during pregnancy--diagnostic dilemma]

A 43-year old gravida 4, para 3 woman in 22 weeks of gestation was admitted because of severe upper abdominal pain. On arrival at the hospital a complete blood cell count showed anemia with hemoglobin concentration of 9.3 g/dl. Other laboratory results including cancer markers, were normal. Ultrasound examination of abdomen showed tumor (diameter 7 cm) of heterogeneous echogenicity localized in lieno-renalis area. Magnetic resonance imaging revealed hyper intensive retroperitoneal masses in the left adrenal region not changing after contrast administration. Hormonal adrenal profile was normal. In 28 week of gestation ultrasound examination showed a significant decrease of tumor size and normal laboratory results. The patient was followed up on an outpatient basis without complication until readmission in 36 week of gestation for preterm labor. Three weeks later a cesarean section was performed. At the time of operation any retroperitoneal masses were not found. Clinical presentation, diagnostic procedures and the course of pregnancy let us to diagnose idiopathic retroperitoneal hematoma.