Expanding hematoma after extraperiosteal paraffin plombage.

Purpose: The development of a chronic expanding hematoma after paraffin plombage has not yet been reported because the procedure was performed only at a limited number of institutes during the short period before the development of antituberculous drugs. We herein report eight patients with chronic expanding hematoma several decades after undergoing extraperiosteal paraffin plombage.

Methods: We reviewed eight surgically treated patients with chronic expanding hematoma after undergoing extraperiosteal paraffin plombage.

Results: Swelling of the plombage space was shown in a chest roentgenogarm and a contrast-enhanced computed tomographic scan as an expanding inhomogeneous mass with subcapsular enhancements. The patient symptoms included a chest or axillary tumor in three patients, and shoulder pain in two, while three were asymptomatic prior to radiological evidence of disease progression. No tuberculous bacillus was detected on microbacterial examination. Both the paraffin and hematomas were removed. The average operative bleeding was 161 ml. One patient underwent muscle transposition for postoperative infection of the residual space. Following the operation, seven patients remained free from the disease and one had hematoma recurrence 9 years later, which was again removed.

Conclusion: A chronic expanding hematoma following extraperiosteal paraffin plombage is a rare complication. However, this disease should be considered when a patient who has undergone paraffin plombage presents with late complications.