Hemophilic Pseudotumors: Diagnosis and Management

Abstract

Prevention is essential for avoiding the complications of muscle hematomas (pseudotumors, compartment syndromes<br />and peripheral nerve lesions) in hemophilic patients. This is achieved through early diagnosis of muscle hematomas<br />and proper long-term hematological treatment until they have resolved (confirmed by image studies). Ultrasound-guided<br />percutaneous drainage could be beneficial in terms of achieving better and faster symptom relief. When suspecting<br />a hemophilic pseudotumor, biopsy will help us confirm the diagnosis and rule out true tumors (chondrosarcoma,<br />liposarcoma, synovial sarcoma) that sometimes mimic hemophilic pseudotumor. Surgical removal of hemophilic<br />pseudotumor is the best solution. As alternatives, there are curettage and filling with cancellous bone and radiotherapy<br />(when surgery is contraindicated). Preoperative arterial embolization (ideally 2 weeks before surgery) helps control<br />intraoperative bleeding during surgery for giant pelvic pseudotumors.<br />Level of evidence: III