Abdel Al Samer, Abou Chaar Mohamad K, Asha Wafa, Ellati Riyad T, Abdeljalil Riad, Bitar Ayman, Al-Qawasmi Muhamad, Hajir Maysoun, Elfarr Salam
Department of Orthopedic Oncology, Hand, and Microsurgery, King Hussein Cancer Center, Jordan E-mail:
Department of Surgery, King Hussein Cancer Center, Jordan.
Qatar Med J. 2022 Jun 4;2022(3):20. doi: 10.5339/qmj.2022.20. eCollection 2022.
An extremely rare manifestation of perigraft seroma (PGS), in which a dense, semisolid jelly-like mass had formed around the shunt instead of the standard fluid-like form of the usual seroma, leading to misdiagnosis with other entities, such as tumors around the synthetic arterio-venous shunt (AVS) was presented.
A 64-year-old male with multiple myeloma post autologous bone marrow transplant with a renal impairment, presented with a rare form of PGS, which was noticed 2 months after placing a synthetic AVS vascular graft. The mass increased in size, and multiple attempts for excision failed due to recurrence, which led to tumor misdiagnosis. The mass reoccurrence stopped completely only after the radical shunt removal.
This case report revealed a rare form of PGS, in which the seroma was represented as a firm, semisolid jelly-like mass rather than the typical fluid type transudate seroma. Despite its rarity, it was associated with a high recurrence rate because unlike the standard perishunt seroma, this semisolid jelly-like material could neither be aspirated, nor could it be resected en-bloc, leading to shunting dysfunction. Its management included advanced imaging and a high probability of shunt removal or replacement.
报道了一种极为罕见的移植周围血清肿（PGS）表现形式，即分流管周围形成了致密的半固体胶冻状肿块，而非常见血清肿的标准液体状，导致与其他病症（如人工动静脉分流术（AVS）周围的肿瘤）发生误诊。
一名64岁男性，自体骨髓移植后患有多发性骨髓瘤且肾功能受损，出现了一种罕见的PGS形式，在植入人工AVS血管移植物2个月后被发现。肿块体积增大，因复发多次切除尝试均失败，导致肿瘤误诊。仅在彻底移除分流管后肿块复发才完全停止。
本病例报告揭示了一种罕见的PGS形式，其中血清肿表现为坚实的半固体胶冻状肿块，而非典型的液体型漏出性血清肿。尽管其罕见，但与高复发率相关，因为与标准的分流管周围血清肿不同，这种半固体胶冻状物质既不能抽吸，也不能整块切除，导致分流功能障碍。其治疗包括先进的影像学检查以及很高的分流管移除或更换可能性。
