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Shimagaki T, Sugimachi K, Mano Y, Tomino T, Onishi E, Taguchi K, Morita M, Toh Y. Chronic expanding hematoma of the liver: a case report and review of the literature. Clin J Gastroenterol 2024; 17:93-99. [PMID: 37751079 DOI: 10.1007/s12328-023-01864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023]
Abstract
Chronic expanding hematoma (CEH) is defined as a hematoma that grows slowly over a month or longer. CEH with a primary hepatic origin is extremely rare. An 85-year-old man presented with general malaise and low-grade fever. His medical history included hypertension and postoperative appendicitis, and he was taking oral aspirin. Computed tomography showed a 7-cm mass in liver S7 with calcification at the margin. On contrast-enhanced magnetic resonance imaging, the inside of the mass showed heterogeneous hyperintensity on T1-weighted images, mainly low intensity on T2-weighted images, and mild hyperintensity in some areas. Under the preoperative diagnosis of suspected CEH, hemorrhagic cyst, or hepatocellular carcinoma, S7 partial liver resection and cholecystectomy were performed. Histopathological findings showed that the mass was continuous with the liver and protruded extrahepatically, and was covered with a hard fibrous capsule. The capsule contained hematomas ranging from obsolete to relatively fresh, with no neoplastic lesions. He was diagnosed with CEH in the liver. This subcapsular hepatic hematoma was pathologically shown to be a CEH. Complete surgical resection was effective in treating this CEH in the liver.
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Affiliation(s)
- Tomonari Shimagaki
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811-1395, Japan.
| | - Keishi Sugimachi
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811-1395, Japan
| | - Yohei Mano
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811-1395, Japan
| | - Takahiro Tomino
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811-1395, Japan
| | - Emi Onishi
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811-1395, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, 811-1395, Japan
| | - Masaru Morita
- National Hospital Organization Kyushu Cancer Center, Fukuoka, 811-1395, Japan
| | - Yasushi Toh
- National Hospital Organization Kyushu Cancer Center, Fukuoka, 811-1395, Japan
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Inomata M, Kuroki S, Nakada H, Kawano F, Maeda R. Radiological features of intrathoracic chronic expanding hematoma: A case report. Int J Surg Case Rep 2023; 110:108767. [PMID: 37683511 PMCID: PMC10510069 DOI: 10.1016/j.ijscr.2023.108767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/27/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE We present a relatively rare case of intrathoracic chronic expanding hematoma (CEH) after thoracic surgery for lung cancer. CEH is often difficult to distinguish from malignant tumors because of its large size and slow progressive enlargement. In this report, we describe the radiological features of CEH in detail. CASE PRESENTATION A 67-year-old man who underwent a left upper lobectomy for lung cancer at 46 years of age presented with hemosputum. Computed tomography revealed a large mass with central low attenuation. Calcification was detected in peripheral lesions of the mass. T2-weighted magnetic resonance imaging (MRI) revealed a mass with mixed low and high signal intensities. Based on the clinical course, the patient was diagnosed with an intrathoracic CEH. A left posterolateral thoracotomy was performed with the patient in the lateral position, and a mass encased in a tough capsule was resected. The postoperative histopathological findings were consistent with CEH. CLINICAL DISCUSSION CT of intrathoracic CEH shows a lesion with heterogeneous content, a thick wall, and calcifications. However, differentiation from malignant tumors is difficult using CT alone. MRI is a good diagnostic modality for CEH and often shows a mixture of low- and high-intensity areas on T2-weighted images. In addition, the patient's medical history is important because most cases of CEH have a history of trauma or surgery. CONCLUSION To diagnose intrathoracic CEH, it is essential to consider the patient's clinical course and MRI findings.
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Affiliation(s)
- Mayu Inomata
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shoei Kuroki
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hiroshi Nakada
- Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Fumiya Kawano
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ryo Maeda
- Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
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Ogata Y, Kumagai K, Mimura T, Miyahara S, Egawa M, Saito H, Amano Y, Yayama T, Kubo M, Imai S. Onset of Chronic Expanding Hematoma 25 Years After Total Hip Arthroplasty. Arthroplast Today 2023; 22:101168. [PMID: 37497549 PMCID: PMC10365973 DOI: 10.1016/j.artd.2023.101168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 07/28/2023] Open
Abstract
Chronic expanding hematoma (CEH) is a rare anatomical condition that gradually expands due to trauma or surgery. We report the case of a 56-year-old woman who developed CEH 25 years after metal-on-polyethylene total hip arthroplasty. She presented with swelling and radiating pain in the right inguinal region. Tocilizumab was administered for treating rheumatoid arthritis and renal amyloid A amyloidosis. Diagnostic imaging and partial resection revealed a soft tissue mass and a CEH, respectively. The symptoms recurred 6 months later; dialysis was initiated, and the CEH was resected under general anesthesia, leading to improvement. This case report emphasizes the importance of prompt diagnosis and intervention in CEH management for preventing further complications and improving the patient's quality of life.
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Affiliation(s)
| | - Kosuke Kumagai
- Corresponding author. Department of Orthopaedic Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan. Tel.: +81 77 548 2252.
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Successful Treatment for a Large Chronic Expanding Hematoma Treated by Pneumonectomy after Arterial Embolization. Case Rep Pulmonol 2022; 2022:1932420. [PMID: 35223122 PMCID: PMC8881156 DOI: 10.1155/2022/1932420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/02/2022] [Indexed: 11/18/2022] Open
Abstract
A chronic expanding hematoma is a rare late complication of thoracoplasty for tuberculosis, before the development of drugs. Total resection of a chronic expanding hematoma often requires invasive surgery consisting of combined resection of the lung and chest wall, accompanied by intraoperative bleeding. We report a case of successful surgical resection of a chronic expanding hematoma with preoperative arterial embolization, 48 years after extraperiosteal paraffin plombage for pulmonary tuberculosis. The operative indication or procedure for a chronic expanding hematoma should be determined carefully, and preoperative preparations as well as strategies should be elaborated for safe surgical resection. It is important to share information about treatment for a large chronic expanding hematoma, as we may continue to encounter this complication over the long term.
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5
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Hill AG. Expanding haematoma in a lace monitor (
Varanus varius
). VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ono Y, Kariya S, Nakatani M, Ueno Y, Maruyama T, Komemushi A, Kaibori M, Ikeda M, Tanigawa N. Subcapsular hepatic hematoma: a case of chronic expanding hematoma of the liver. BMC Gastroenterol 2021; 21:241. [PMID: 34044783 PMCID: PMC8161977 DOI: 10.1186/s12876-021-01775-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/20/2021] [Indexed: 11/22/2022] Open
Abstract
Background A chronic expanding hematoma (CEH) enlarges as a result of slight bleeding over several months, and the tissue shows a mixture of blood breakdown products, granulation tissue with capillary ingrowth, and inflammatory tissue. This report presents a case of a subcapsular hepatic CEH that was treated with transarterial embolization (TAE) and hepatectomy. Case presentation A 56-year-old man presented with vomiting and right-sided abdominal pain. Plain abdominal computed tomography (CT) showed a high-density area of fluid collection beneath the capsule of the right hepatic lobe, which was diagnosed as a hematoma. From its anatomical position on the CT images, a subcapsular hepatic hematoma was diagnosed. Though conservative therapy was provided, CT-guided percutaneous drainage and TAE were performed due to worsening symptom. Because the patient's abdominal symptoms re-appeared, extended right segmentectomy including the hematoma was performed. In the resected specimen, the hematoma was located beneath the capsule of the right hepatic lobe, and it was displacing the hepatic parenchyma. Microscopic examination showed a thick fibrous capsule around the hematoma, peripheral lymphocyte and plasmacyte invasion, and aggregations of histiocytes containing phagocytosed hemosiderin. Conclusions Anatomically, this was a case of a subcapsular hepatic hematoma, and pathologically it was shown to be a CEH. Complete surgical resection was effective treatment for this CEH.
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Affiliation(s)
- Yasuyuki Ono
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Shuji Kariya
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
| | - Miyuki Nakatani
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Yutaka Ueno
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Takuji Maruyama
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Atsushi Komemushi
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Masaki Kaibori
- Department of Surgery, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, 573-1010, Osaka, Japan
| | - Masatoshi Ikeda
- Department of The Third Internal Medicine, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, 573-1010, Osaka, Japan
| | - Noboru Tanigawa
- Department of Radiology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
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Sakamoto A, Okamoto T, Tsuboyama T, Matsuda S. Chronic Expanding Hematoma in the Thigh: A Late Complication 32 Years After Treatment of Synovial Sarcoma: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1449-1453. [PMID: 31575849 PMCID: PMC6788476 DOI: 10.12659/ajcr.917855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Patient: Female, 49 Final Diagnosis: Chronic expanding hematoma Symptoms: Thigh swelling Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology
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Affiliation(s)
- Akio Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Takeshi Okamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Tadao Tsuboyama
- School of Health Sciences, Bukkyo University, Kyoto City, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
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8
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Yaguchi D, Ichikawa M, Kimura H, Ito M, Watanabe K. Sudden Death Due to Recent Hemorrhage From an Intrathoracic Chronic Expanding Hematoma. J Forensic Sci 2018; 64:625-628. [DOI: 10.1111/1556-4029.13889] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/25/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Daizo Yaguchi
- Department of Respiratory Medicine Gifu Prefectural Tajimi Hospital 5‐161, Maehata‐cho Tajimi Gifu 507‐8522 Japan
| | - Motoshi Ichikawa
- Department of Respiratory Medicine Gifu Prefectural Tajimi Hospital 5‐161, Maehata‐cho Tajimi Gifu 507‐8522 Japan
| | - Hayata Kimura
- Department of Respiratory Medicine Gifu Prefectural Tajimi Hospital 5‐161, Maehata‐cho Tajimi Gifu 507‐8522 Japan
| | - Masao Ito
- Department of Thoracic Surgery Gifu Prefectural Tajimi Hospital 5‐161, Maehata‐cho Tajimi Gifu 507‐8522 Japan
| | - Kazuko Watanabe
- Department of Pathology Gifu Prefectural Tajimi Hospital 5‐161, Maehata‐cho Tajimi Gifu 507‐8522 Japan
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Sakuma T, Takayashiki N, Iguchi K, Kagohashi K, Satoh H, Nakazawa K, Hizawa N. Chronic expanding hematoma in the chest: A case report. Exp Ther Med 2018; 15:5457-5460. [PMID: 29844806 DOI: 10.3892/etm.2018.6091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/14/2017] [Indexed: 11/06/2022] Open
Abstract
Chronic expanding hematoma (CEH) is a rare disease that is usually present as a large solitary pulmonary nodule. CEHs are slow growing, but processes underlying their development remain unknown. The present study herein reports the case of a 76-year-old male patient with CEH and discusses a number of CEH cases published in the literature. The majority of these previously described patients were Asians. The CEH in the present case was not a successfully resected one, but the patient's clinical course provided information concerning the natural history of the disease. During the clinical course, the patient underwent several chest computed tomography scans. For the present case report, the doubling time and volume change of the mass was calculated, which revealed that the lesion had an inconstant growth rate and that its onset was between 8.2-11.0 years before the patient succumbed to this disease. Accumulation of knowledge about this rare disease will help to elucidate it further.
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Affiliation(s)
- Takafumi Sakuma
- Division of General Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Mito, Ibaraki 310-0015, Japan
| | - Norio Takayashiki
- Division of Pathology, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Mito, Ibaraki 310-0015, Japan
| | - Kesato Iguchi
- Division of Surgery, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Mito, Ibaraki 310-0015, Japan
| | - Katsunori Kagohashi
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Mito, Ibaraki 310-0015, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Mito, Ibaraki 310-0015, Japan
| | - Kensuke Nakazawa
- Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Nobuyuki Hizawa
- Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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10
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Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues. BIOMED RESEARCH INTERNATIONAL 2017. [PMID: 28642872 PMCID: PMC5469981 DOI: 10.1155/2017/4634350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
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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Sakamoto A, Matsuda S. Chronic expanding hematoma: a late complication 45 years after thoracoplasty. J Thorac Dis 2017; 9:E6-E9. [PMID: 28203429 DOI: 10.21037/jtd.2017.01.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A chronic expanding hematoma is a hematoma with long term, continuous growth. A 69-year-old male presented with an extra-thoracic chronic expanding hematoma 45 years after thoracoplasty. Six months prior to his visit with us, he had noticed a slight swelling on his back. Three months before his visit with us, the size of the swollen area gradually increased after bowling. Magnetic resonance imaging (MRI) showed an extra-thoracic lesion measuring 120 mm in diameter. Heterogeneous signal intensity on T1- and T2-weighted images inside the lesion was reflected as hematoma of various ages. The hematoma was successfully resected after preoperative embolization. Chronic expanding hematoma can be a delayed complication after thoracoplasty.
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Affiliation(s)
- Akio Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Dai W, Zhuang X, Li Q, Xiao P, Shen YI, Zheng P. Giant chronic expanding hematoma in the chest identified 25 years after a blunt chest trauma. Mol Clin Oncol 2016; 4:507-509. [PMID: 27073651 PMCID: PMC4812216 DOI: 10.3892/mco.2016.774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 02/03/2016] [Indexed: 11/05/2022] Open
Abstract
We herein report the case of a 42-year-old man who presented with a huge intrathoracic mass that had grown over a period of 25 years. The initial symptom caused by the mass was dull pain in the chest. T2-weighted magnetic resonance imaging revealed a mosaic pattern of various signal intensities, indicating a chronic expanding hematoma. The mass was completely resected surgically. For patients who present with a slowly growing mass, particularly those with a history of tuberculous pleuritis, chest surgery or trauma, a chronic expanding hematoma should be taken into consideration. Surgical resection is the first choice of treatment for a chronic expanding hematoma caused by a blunt chest trauma.
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Affiliation(s)
- Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Xiang Zhuang
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Ping Xiao
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Y I Shen
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Ping Zheng
- Department of Pathology, Sichuan Cancer Hospital, Chengdu, Sichuan 610041, P.R. China
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Ueda H, Baba H, Ondo K. Chronic Expanding Hematoma of Thorax Extended to the Neck. Ann Thorac Cardiovasc Surg 2014; 20 Suppl:535-8. [DOI: 10.5761/atcs.cr.12.02055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hitoshi Ueda
- Department of Surgery, Fukuoka National Hospital, Fukuoka, Japan
| | - Hiromitsu Baba
- Department of Surgery, Fukuoka National Hospital, Fukuoka, Japan
| | - Kaoru Ondo
- Department of Surgery, Fukuoka National Hospital, Fukuoka, Japan
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14
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Treatment of chronic expanding hematoma of the thorax with median sternotomy. Gen Thorac Cardiovasc Surg 2013. [DOI: 10.1007/s11748-012-0183-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Current World Literature. Curr Opin Anaesthesiol 2013; 26:98-104. [DOI: 10.1097/aco.0b013e32835cb4f0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Hata Y, Sakamoto S, Shiraga N, Sato K, Sato F, Otsuka H, Goto H, Takagi K, Watanabe Y. A case of chronic expanding hematoma resulting in fatal hemoptysis. J Thorac Dis 2012; 4:508-11. [PMID: 23050116 DOI: 10.3978/j.issn.2072-1439.2012.08.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 08/21/2012] [Indexed: 11/14/2022]
Abstract
An 80-year-old woman presented with a huge intrathoracic mass which had increased in size over 4 years. Computed tomography showed a thick calcified capsule and early-enhanced streaks inside the mass. Needle biopsy aspirated pure blood and fibrous connective tissue. F-18 fluorodeoxyglucose positron-emission tomography showed moderate FDG uptake at the periphery with central photon defects. Gallium-67 scintigraphy showed no abnormal uptake. On suspicion of chronic expanding hematoma, we recommended surgical resection, but the patient requested only follow-up. One year later, she was hospitalized with cardiac tamponade and subsequent massive hemoptysis. Repeated embolization was ineffective, and the patient soon succumbed.
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Affiliation(s)
- Yoshinobu Hata
- Department of Chest Surgery, Toho University Omori Medical Center, Tokyo, Japan
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