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Surgical Excision of a Hemophilic Pseudotumor Causing Vascular Impingement in a Patient with Severe Hemophilia A: A Case Report.

Rev Bras Ortop (Sao Paulo)

November 2024

Departamento de Cirurgia Ortopédica, Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colômbia.

Patients with hemophilia disease have a high risk of hemorrhage. Most hemorrhages can occur in the musculoskeletal system, presenting as hematomas, or, in rare occasions, as hemophilic pseudotumors, an uncommon pathology that are often misdiagnosed as musculoskeletal tumors because of their clinical behavior and characteristics on diagnostic imaging. Despite many treatment options, surgical excision is the treatment of choice.

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Aim: Hemophilic pseudotumor (HP) is a very rare complication of hemophilia seen in only 1-2% of the cases. Although it is much more common in long bones, pelvis and small bones of hands and feet and very rarely involving jaw bones.

Method And Result: In the present case, the presence of a rare hemophilic pseudotumor of the mandible with the positive history of Hemophilia B justifies that the history, clinical and radiological examinations were sufficient to arrive at conclusive diagnosis precluding invasive diagnostic procedures such as biopsy hence avoiding the risk of hemorrhage, infection, or fistula.

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Hemophilic pseudotumor (HP) is a rarely encountered cystic mass that forms as a result of repeated bleeding from extra-articular soft tissues. HP cases have been previously documented in several locations in the body, most commonly in the femur and pelvis. To date, no upper extremity case involving the bilateral forearms has been reported.

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Pseudotumours are uncommon complications of haemophilia, occurring in 1%-2% of patients with haemophilia. It is a slowly expanding haematoma as a result of recurrent haemorrhage, surrounded by a fibrous capsule. It can occur in both bone and soft tissue, and progressive enlargement may result in bone destruction and/or muscle and skin necrosis.

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