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

Morioka, Daichi; Ohkubo, Fumio; Umezawa, Kazuya

doi:10.1016/j.ijscr.2014.03.002

Cited by 7 publications

(2 citation statements)

References 3 publications

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“…16 There are many reports of CEH in the literature, virtually all of many years duration. [17][18][19] Histologically, these chronic hematomas exhibit a fibrous-walled cyst with a pseudocapsule of variable thickness, often with scattered clusters of histiocytes and hemosiderin deposition; mild chronic inflammation and foci of granulation tissue may be present. 15,16,18 Although the cases described here all conform to the Reid definition of CEH, we required a minimum of 1-year duration to preclude cases of de novo AS presenting as simple hemorrhagic cysts; such cases are typically diagnosed in several months time, and have no circumferential fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…16 These fibrous-walled cystic lesions can be found in many bodily sites including extremities, retroperitoneum, pleural cavity, and paraspinal region. [17][18][19] Although typically preceded by trauma, CEH can also develop in the postsurgery setting. Morphologically, CEH is commonly described as a mass of fresh and aging blood or fibrin thrombus debris surrounded by a dense fibrous capsule of variable thickness.…”

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Angiosarcoma Arising in Chronic Expanding Hematoma

Burgert-Lon

Riddle

Lackman

et al. 2015

American Journal of Surgical Pathology

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Little is known about the etiology or pathogenesis of angiosarcoma (AS). We describe a series of 5 cases of AS arising in chronic expanding hematomas. Inclusion criteria were the presence of a hematoma of at least 1-year duration and a thick fibrous wall surrounding the hematoma. Patients were 4 men and 1 woman; ages ranged from 43 to 71 years. Locations were the thigh (3), chest wall (1), and pelvic soft tissue involving the ischial bone (1). Hematoma duration ranged from 2 to 25 years. All cases had large cystic hematomas >10 cm; 2 had prior radiation. Thick fibrous walls surrounded the hematomas, with foci of hemosiderin and foamy histiocytes. Wall thickness ranged from 0.2 to 1.0 cm and varied within lesions. All AS were epithelioid, and in 3 cases the tumor invaded through the cyst wall. Immunoreactive nuclear c-myc was noted in 3/3 cases available for testing. Follow-up disclosed 4 patients developed metastatic disease, 3 of whom died of disease, 4, 8, and 15 months after diagnosis; the fourth patient is alive without disease after chemotherapy at 59 months. One patient without metastases is alive without disease 18 months after diagnosis; this tumor was confined to the cyst without penetration through the wall. We identified 4 similar cases in the literature, 3 as individual case reports (all epithelioid AS), and 1 as part of a series of AS. To our knowledge, this is the first series of AS arising in chronic expanding hematomas. Recognition of this unusual complication should alert clinicians to provide periodic clinical follow-up to these patients and to biopsy any case with sudden or uncontrolled enlargement. We recommend that excised chronic hematomas be well sampled histologically to search for AS and, if identified, to determine its extent and invasiveness.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Angiosarcoma Arising in Chronic Expanding Hematoma

Burgert-Lon

Riddle

Lackman

et al. 2015

American Journal of Surgical Pathology

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Telangiectatic soft tissue sarcoma and chronic expanding haematoma: a comparative review of MRI features

Tilden

Saifuddin

2021

Skeletal Radiol

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Chronic Expanding Hematoma Following Abdominoplasty

et al. 2016

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Chronic expanding hematoma (CEH) is a relatively rare complication of trauma or surgery. We report a patient with CEH as a late complication of abdominoplasty. A 58-year-old woman underwent conventional abdominoplasty and thereafter refused to use a compression binder, citing discomfort. One month postoperatively, she presented with a gradually enlarging, painful abdominal mass. The results of ultrasonography and computed tomography were highly suspicious for CEH. The lesion was completely removed, together with surrounding fibrous tissue. Histopathology revealed a chronic hemorrhage collection with a fibrous capsule, consistent with CEH. This condition as a late complication of abdominoplasty has not previously been reported in the literature. However, an online medical consultation site features several abdominoplasty patients asking about persistent hematomas that sound suspicious for CEH. CEH might be underdiagnosed by surgeons. Although a postoperative binder may increase the risk of skin necrosis and deep vein thrombosis, appropriate compression treatment is necessary to prevent hematoma formation. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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

Cited by 7 publications

References 3 publications

Angiosarcoma Arising in Chronic Expanding Hematoma

Angiosarcoma Arising in Chronic Expanding Hematoma

Telangiectatic soft tissue sarcoma and chronic expanding haematoma: a comparative review of MRI features

Chronic Expanding Hematoma Following Abdominoplasty

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