Morioka Daichi, Ohkubo Fumio, Umezawa Kazuya
Department of Plastic and Reconstructive Surgery, Showa University, Tokyo, Japan.
Department of Plastic and Reconstructive Surgery, Showa University, Tokyo, Japan.
Int J Surg Case Rep. 2014;5(6):342-4. doi: 10.1016/j.ijscr.2014.03.002. Epub 2014 Mar 20.
Chronic expanding hematoma is a relatively rare complication of soft tissue trauma and often clinically mistaken for a malignant neoplasm.
A 71-year-old female presented with a chronic expanding hematoma that ruptured through the buttock skin 53 years after the original contusion. The diagnosis of CEH was made based on the results of the biopsy, physical examination, and CT. The tumor was completely excised, and the defect was covered with a rhomboid flap.
There are no reports of lesions rupturing through the skin. Almost all instances of chronic expanding hematoma previously reported in the English literature have a history ranging from 1 month to 20 years. There is a report of a thorax CEH that ruptured into the lung parenchyma after 24 years, so it is conceivable that other subcutaneous CEHs could break through the skin several decades after their inception.
Once this lesion has ruptured, its differentiation from other entities becomes more complicated.
慢性扩张性血肿是软组织创伤相对罕见的并发症,临床上常被误诊为恶性肿瘤。
一名71岁女性,最初挫伤53年后出现慢性扩张性血肿,并穿破臀部皮肤。根据活检、体格检查及CT结果诊断为慢性扩张性血肿。肿瘤被完整切除,缺损处用菱形皮瓣覆盖。
此前尚无病变穿破皮肤的报道。几乎所有英文文献中报道的慢性扩张性血肿病例,病程从1个月至20年不等。有一篇报道称,胸部慢性扩张性血肿24年后破入肺实质,因此可以想象,其他皮下慢性扩张性血肿在发病数十年后可能穿破皮肤。
一旦该病变发生破裂,其与其他病变的鉴别将变得更加复杂。