Chronic Expanding Hematoma-Report of 2 Cases
摘要
Background:Chronic expanding hematoma is referred to as hematoma that has persisted and increased in size for more than a month after the initiating hemorrhage. Chronic expanding hematoma over soft tissue can manifest as a space-occupying lesion which mimics a sarcoma and is a challenge for clinical doctors.Aim and Objectives:Here we report two such cases, one in a long-ago free latissimus dorsi flap donor site and a second one on the cheek, clinically indistinguishable from soft tissue sarcoma.Materials and Methods:Case 1 is a 42-year-old man who had a left tibia-fibula open fracture status post free latissimus dorsi flap reconstruction 19 years ago. He presented himself to our ER with an enlarged back mass over the flap donor site about 12 × 18 cm for 1 month. Case 2 is a 30-year-old woman with a history of acute lymphoblastic leukemia in complete remission. She had a gradually enlarging swelling over left cheek for 3 months, and core needle biopsy revealed a spindle cell tumor. Both of the cases underwent surgical exploration and the pathology revealed organized hematoma.Results:Chronic expanding hematomas in the latissimus dorsi flap donor site and cheek have rarely been reported in the literature. Spindle cells, such as myofibroblasts, may be present in the chronic expanding hematoma during the process of scarring. A single biopsy may lead to a totally different diagnosis.Conclusion:It was difficult to obtain a definitive diagnosis of the patients with chronic expanding hematoma before surgery. As surgeons, we should consider this disease in cases of a gradually expanding mass.