Matsumura Ikuko, Yanagisawa Kunio, Ogawa Yoshiyuki, Shimizu Hiroaki, Ishizaki Takuma, Mitsui Takeki, Uchiumi Hideki, Uchiyama Yuri, Matsumuto Naomichi, Handa Hiroshi
Department of Hematology, Gunma University Hospital.
Hidaka-kai Shirane Clinic.
Rinsho Ketsueki. 2018;59(3):287-292. doi: 10.11406/rinketsu.59.287.
Hemophilic pseudotumors can occur in patients with hemophilia because of recurrent bleeding and poor hemostasis. A man in his 30s with hemophilia B and human immunodeficiency virus/hepatitis C virus co-infection complicated by liver cirrhosis presented with a large pseudotumor in the left iliopsoas muscle. However, resting to stop bleeding was difficult with his daily work. Osteolytic changes in the left ilium progressed over 8 years. A large osteolytic pseudotumor in the pelvis was also incidentally identified in his younger brother during his 30s. The same mutations in F9 (p. Arg294Gln, hemizygous mutation) associated with a non-severe phenotype were detected in both brothers. The clinical courses of the brothers suggested that large pseudotumors can occur in patients with non-severe hemophilia and underline the importance of patient education.
血友病性假肿瘤可发生于血友病患者，原因是反复出血和止血功能不佳。一名30多岁的男性，患有乙型血友病且合并人类免疫缺陷病毒/丙型肝炎病毒感染，并伴有肝硬化，左髂腰肌出现一个巨大的假肿瘤。然而，由于日常工作，他很难通过休息来止血。左髂骨的骨质溶解改变在8年中逐渐进展。在他30多岁的弟弟中，也偶然发现骨盆有一个巨大的溶骨性假肿瘤。在两兄弟中均检测到F9基因相同的突变（p.Arg294Gln，半合子突变），该突变与非严重表型相关。兄弟俩的临床病程表明，非严重血友病患者也可出现巨大假肿瘤，并凸显了患者教育的重要性。
