Hemophilic pseudotumors: Diagnosis and management
Author
E. Carlos Rodríguez-MerchánEntity
UAM. Departamento de Cirugía; Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)Publisher
Official international journal of the Iranian Orthopedic Association (IOA); Iranian Society of Knee Surgery, Arthroscopy & Sport Traumatology (ISKAST) and Iranian Orthopedic Research Society (IORS).Date
2020-03-01Citation
10.22038/abjs.2019.40547.2090
Archives of Bone and Joint Surgery 8.2 (2020): 121-130
ISSN
2345-4644DOI
10.22038/abjs.2019.40547.2090Editor's Version
https://doi.org/10.22038/abjs.2019.40547.2090Subjects
Hemophilia; Muscle hematomas; Prevention; Pseudotumors; Treatment; MedicinaRights
© 2020 Archives of Bone and Joint SurgeryAbstract
Prevention is essential for avoiding the complications of muscle hematomas (pseudotumors, compartment syndromes and peripheral nerve lesions) in hemophilic patients. This is achieved through early diagnosis of muscle hematomas and proper long-term hematological treatment until they have resolved (confirmed by image studies). Ultrasound-guided percutaneous drainage could be beneficial in terms of achieving better and faster symptom relief. When suspecting a hemophilic pseudotumor, biopsy will help us confirm the diagnosis and rule out true tumors (chondrosarcoma, liposarcoma, synovial sarcoma) that sometimes mimic hemophilic pseudotumor. Surgical removal of hemophilic pseudotumor is the best solution. As alternatives, there are curettage and filling with cancellous bone and radiotherapy (when surgery is contraindicated). Preoperative arterial embolization (ideally 2 weeks before surgery) helps control intraoperative bleeding during surgery for giant pelvic pseudotumors.
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