Chronic expanding hematoma of the thigh

Negoro, Kohei; Uchida, Kenzo; Yayama, Takafumi; Kokubo, Yasuo; Baba, H.

doi:10.1016/j.jbspin.2011.08.002

Cited by 38 publications

(43 citation statements)

References 16 publications

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“…In rare cases, hematomas slowly increase in size and are then referred to as chronic expanding hematomas [1, 2]. The chronic expanding hematoma is characterized by a mixture of old and new blood, accompanied by necrotic degradation and liquefaction and a fibrous pseudocapsule [2]. An association with trauma has been reported [2].…”

Section: Introductionmentioning

confidence: 99%

“…The chronic expanding hematoma is characterized by a mixture of old and new blood, accompanied by necrotic degradation and liquefaction and a fibrous pseudocapsule [2]. An association with trauma has been reported [2]. Chronic expanding hematomas occur in various locations [1, 2].…”

Section: Introductionmentioning

confidence: 99%

“…An association with trauma has been reported [2]. Chronic expanding hematomas occur in various locations [1, 2]. In this report, we analyze patients with chronic expanding hematomas of the extremities.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Sakamoto

Okamoto

Matsuda

2017

BioMed Research International

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Chronic expanding hematoma is characterized by continuous growth of a blood collection. We analyzed the clinical features of 7 patients with chronic expanding hematomas in the extremities, with an average age of 65.6 years. All lesions occurred in the lower extremities, with 4 seen in the thigh and 3 in the knee region. Six patients had subcutaneous hematomas, while 1 was deep-seated in the thigh. The magnetic resonance features of the lesion were compatible with those of a standard hematoma. A low signal intensity on T1- and T2-weighted imaging at the pseudocapsule was also characteristic. Cystic features were seen in 5 of 7 patients. All lesions were resected together with their pseudocapsule. In the subcutaneous lesions, it was necessary to resect adherent fascia, with or without involved skin. In the deep-seated thigh lesion, the common peroneal nerve was completely adherent to the pseudocapsule, a phenomenon from absence of the common peroneal nerve which appeared after resection. Chronic expanding hematomas of the extremities are predominantly located in the subcutaneous tissue of the lower extremity. The surrounding pseudocapsule is adherent to the adjacent tissues, and clinicians must be aware of this, especially when resecting a deep-seated lesion.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Sakamoto

Okamoto

Matsuda

2017

BioMed Research International

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“…In these cases, definitive diagnosis of CEH depends on histopathology. On histopathologic examination, the CEH is well encapsulated and the capsule walls uniformly consist of an outer fibrocollagenous layer and an inner granulation layer [11]. …”

Section: Discussionmentioning

confidence: 99%

Huge chronic expanding hematoma of the iliac bone following multiple hip surgeries: a case report

et al. 2018

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BackgroundChronic expanding hematoma is a rare entity resulting from trauma or surgery. This condition usually occurs in soft tissue, such as the trunk or extremities, while chronic expanding hematoma arising from bone has not been reported previously. We describe an unusual case of a huge intraosseous chronic expanding hematoma arising from the ilium, which had grown over a 40-year period following hip surgeries.Case presentationA 57-year-old Japanese woman presented with a 1.5-year history of right hip pain. She had a history of bilateral developmental dysplasia of the hip and had undergone bilateral arthroplasties in childhood. A physical examination revealed a large, firm, immobile mass at her right ilium. Based on radiographic findings, a type of slow-growing bone tumor was suspected, and an incisional biopsy was performed. A histopathologic examination revealed large amounts of old clotted blood within the lesion, and the capsule of the lesion was composed of dense, fibrous, connective tissue. There was no evidence of neoplasia, and chronic expanding hematoma was suspected. The lesion was resistant to conservative treatment, and so we performed an internal hemipelvectomy (including the capsule of the mass) and a reconstruction by hip transposition 2.5 years after the incisional biopsy. There was no recurrence of chronic expanding hematoma at the most recent follow-up of 1 year and 8 months postoperatively.ConclusionsA chronic expanding hematoma is characterized by its persistence and increasing size more than 1 month after the trauma or surgical event suspected of causing hemorrhage. To the best of our knowledge, this is the first report of chronic expanding hematoma arising from bone. We performed internal hemipelvectomy and hip transposition, and there has so far been no recurrence. This disease may be considered a differential diagnosis for bone tumor when the patient has a history of surgery or trauma, regardless of how many years have passed since the index event.

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“…The pathogenesis of CEH seems to be same as that of chronic subdural hematoma 2 . Chronic inflammation and increased capillary permeability caused by trauma or surgery are implicated, with a critical clot volume needed for enlargement to occur.…”

Section: Discussionmentioning

confidence: 99%

Chronic expanding hematoma, ruptured through the skin 53 years after buttock contusion

Morioka

Ohkubo

Umezawa

2014

International Journal of Surgery Case Reports

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INTRODUCTIONChronic expanding hematoma is a relatively rare complication of soft tissue trauma and often clinically mistaken for a malignant neoplasm.PRESENTATION OF CASEA 71-year-old female presented with a chronic expanding hematoma that ruptured through the buttock skin 53 years after the original contusion. The diagnosis of CEH was made based on the results of the biopsy, physical examination, and CT. The tumor was completely excised, and the defect was covered with a rhomboid flap.DISCUSSIONThere are no reports of lesions rupturing through the skin. Almost all instances of chronic expanding hematoma previously reported in the English literature have a history ranging from 1 month to 20 years. There is a report of a thorax CEH that ruptured into the lung parenchyma after 24 years, so it is conceivable that other subcutaneous CEHs could break through the skin several decades after their inception.CONCLUSIONOnce this lesion has ruptured, its differentiation from other entities becomes more complicated.

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Chronic expanding hematoma of the thigh

Cited by 38 publications

References 16 publications

Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Huge chronic expanding hematoma of the iliac bone following multiple hip surgeries: a case report

Chronic expanding hematoma, ruptured through the skin 53 years after buttock contusion

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