Yeung Caleb Matthew, Blazar Philip
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
BMJ Case Rep. 2019 Sep 6;12(9):e231589. doi: 10.1136/bcr-2019-231589.
A 55-year-old man with a history of haemophilia A and bilateral haemophilic arthropathy of the elbows presented with an enlarging left elbow mass and worsening paresthesias in the ulnar distribution of the left hand. The mass, originally thought to be olecranon bursitis and treated as such, was found to be due to a haemophilic pseudotumour. The patient underwent successful excision of the haemophilic pseudotumour with concomitant ulnar nerve decompression and had sustained resolution of the pseudotumour and symptoms at 10 years of follow-up. This case demonstrates the need for consideration of haemophilic pseudotumour in the differential diagnosis for olecranon masses and cubital tunnel compressive neuropathy in patients with haemophilia, and highlights the viability of surgical excision as a therapeutic option for the treatment of haemophilic pseudotumours in the elbow.
一名55岁男性,有甲型血友病病史及双侧肘部血友病性关节病,因左肘肿物增大及左手尺侧感觉异常加重就诊。该肿物最初被认为是鹰嘴滑囊炎并按此治疗,后来发现是血友病性假肿瘤。患者成功切除血友病性假肿瘤并同时进行尺神经减压,随访10年假肿瘤及症状持续缓解。该病例表明,对于血友病患者的鹰嘴肿物和肘管综合征,鉴别诊断时需要考虑血友病性假肿瘤,并强调手术切除作为肘部血友病性假肿瘤治疗选择的可行性。