Chronic expansive pelvic hematoma: atypical location of pseudotumor. A report of 2 cases.

Main Article Content

Moriel-Garceso Diego Pozo-Kreilinger Jose J Peleteiro-Pensado Manuel Barrientos-Ruiz Irene Ortiz-Cruz Eduardo J

Abstract

Case: Chronic expansive pelvic hematoma is a very rare entity with a few cases published in the literature, being the most frequent locations the thorax and chest. The tumoral mass called pseudotumor produces a large osteolysis in the pelvis with a difficult radiological diagnosis, and not rarely misdiagnosed as sarcoma. The treatment of these type of lesions should be done at a specialized sarcoma centre, and under the supervision of a multidisciplinary committee, that it is enable the correct differential diagnosed and treatment. The pathological analysis is the key point to the diagnosis.


We report two cases located in the pelvis, an extremely rare location.


The resection should be wide to avoid recurrence. The reconstruction in the pelvic cases required “ice-cream cone” prosthesis that provides the restoration of the functionality of the hip.


Conclusion: This rare phenomenon is suspicious for malignant tumour. The treatment of this entities should be evaluated in an expert centre in the treatment of sarcomas.

Article Details

How to Cite
DIEGO, Moriel-Garceso et al. Chronic expansive pelvic hematoma: atypical location of pseudotumor. A report of 2 cases.. Medical Research Archives, [S.l.], v. 10, n. 2, feb. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2601>. Date accessed: 06 dec. 2022. doi: https://doi.org/10.18103/mra.v10i2.2601.
Section
Case Reports

References

1. Franco Filho N, de Paiva Luciano A, Vierno B. Pelvic pseudotumor following total hip arthroplasty-case report. Rev Bras Ortop. 2014;49(5):543-549.
2. Leung P, Kudrna JC. Growth of an intrapelvic pseudotumor associated with a metal-on-metal total hip arthroplasty after revision arthroplasty causing a femoral nerve neuropathy. Arthroplasty Today 2 (2016) 105-109.
3. Goddard MS, Vakil JJ, McCarthy EF, Khanuja HS. Chronic Expanding Hematoma of the Lateral Thigh and Massive Bony Destruction After a Failed Total Hip Arthroplasty. The Journal of Arthroplasty Vol. 26 No.2 February 2011.
4. Bisseling P, Tan T, Lu Z, Campbell PA, Susante JLC. The absence of a metal-on-metal bearing does not preclude the formation of a destructive pseudotumor in the hip-a case report. Acta Orthopaedica 2013;84(4):437-441.
5. Davis DL, Morrison JJ. Hip Arthroplasty Pseudotumors: Pathogenesis, Imaging, and Clinical Decision Making. Journal of Clinical Imaging Science Vol. 6 Issue 2 Apr-Jun 2016.
6. Sakurai J, Akaki S, Yonezawa M, Horiguchi I, Nakamura S, Kanazawa S. Intrapelvic Chronic Expanding Hematoma: Magnetic Resonance Imaging Findings with Pathological Correlation. Magn Reson Med Sci, Vol. 9, No. 2, pp. 81-84, 2010.
7. Samanci C, Ayvaci A, Korkmaz O, Bas A. Pelvic haemophilic pseudotumour in a patient with haemophilia. BMJ Case Rep 2013.
8. Castro-Boix S, Pradell-Teigell J, Boqué-Genovard R, Zanón-Navarro V, Nadal-Guinard A, Altisent-Roca C, Armengol-Carrasco M. Seudotumor hemofílico pelviano. Cir Esp. 2007;81(2):102-4.
9. Frezin J, Marique L, Coubeau L, Hubert C, Lambert C, Hermans C, Jabbour N. Successful emergency resection of a massive intra-abdominal hemophilic pseudotumor. World J Gastrointest Surg 2015 March 27;7(3): 43-46.
10. Ying SH, Chen WM, Wu PK, Chen CF, Liu CL, Chen TH. Pelvic hemophilic pseudotumor presenting as severe sciatic pain in a patient with no history of hemophilic symptoms. J Orthop Sci (2012) 17:490-494.
11. Peleteiro-Pensado M, Ortiz-Cruz E. Articular pseudotumors and bone cysts in the adult hemophilic patient. Chapter 10. In Joint Surgery in the adult patient with hemophilia. Springer Cham Heidelberg New York Dordrecht London; Springer International Publishing Switzarlan 2015. ISBN 978-3-319-10779-0; ISBN 978-3-319-10780-6 (eBook); DOI 10.1007/978-3-319-10780-6.
12. Almousa SA, Greidanus NV, Masri BA, Duncan CP, Garbuz DS. The Natural History of Inflammatory Pseudotumors in Asymptomatic Patients After Metal-on-metal Hip Arthroplasty. Clin Orthop Relat Res (2013) 471:3814-3821.
13. Leigh W, O´Grady P, Lawson EM, Theis JC, Matheson J. Pelvic pseudotumor: an unusual presentation of an extra-articular granuloma in a well-fixed total hip arthroplasty. The Journal of Arthroplasty Vol. 23 No. 6 September 2008.
14. Chu-Wei L, Chun-Lin K, Tsung-Ying T, Leou-Chyr L, Chia-Chun W. Massive gluteal mass mimicking sarcoma: Chronic expanding hematoma. Formosan Journal of Musculoskeletal Disorders 2 (2011) 106-108.
15. Mao X, Tay GH, Godbolt DB, Crawford RW. Pseudotumor in a well-Fixed metal-on-polyethylene uncemented hip arthroplasty. The Journal of Arthroplasty Vol. 27 No. 3 2012.
16. Murgatroyd S. Pseudotumor Presenting as a Pelvic Mass: A Complication of Eccentric Wear of a Metal on Polyethylene Hip Arthroplasty. The Journal of Arthroplasty Vol. 27 No. 5 2012.
17. Uchida K, Negoro K, Kokubo Y, Yayama T, Miyazaki T, Nakajima H, Yoshida A, Baba H. Retroperitoneal hematoma with bone resorption around the acetabular component after total hip arthroplasty: a case report and review of the literature. Journal of Medical Case Reports 2012, 6:294.
18. Nicolli A, Trevisan A, Bortoletti I, Pozzuoli A, Ruggieri P, Martinelli A, Gambalunga A, Carrieri M. Biological Monitoring of Metal Ions Released from Hip Prostheses. Int J. Environ. Res. Public Health 2020, 17, 3223; doi:10.3390/ijerph17093223.
19. Singh C, Kaplan A, Pambuccian SE. Necrotic granulomatous pseudotumor following metal-on-metal hip arthroplasty: a potential mimic of sarcoma on fine needle aspiration cytology. Diagn Cytopathol. 2012 Aug;40 Suppl 2:E104-8.
20. Visuri T, Pulkkinen P, Paavolainen P. Malignant Tumors at the Site of Total Hip Prosthesis. Analytic Review of 46 Cases. The Journal of Arthroplasty Vol. 21 No. 3 2006.
21. Barrientos-Ruiz I, Ortiz-Cruz EJ, Peleteiro-Pensado M. Reconstruction After Hemipelvectomy With the Ice-Cream Cone Prosthesis: What Are the Short-term Clinical Results? Clin Orthop Relat Res (2017) 475:735-741.
22. Ma HY, Feng MT, Hong YG. Calcifying fibrous pseudotumor in the pelvic cavity: A case report and review of the literature. Molecular and Clinical Oncology 12: 268-272, 2020.