Kuwahara Masamitsu, Wada Takuya, Masuda Yasumitsu, Miyata Riyo, Harada Masayuki, Ogawa Kohei
From the Division of Plastic Surgery, Nara Medical University Hospital, Nara, Japan.
Department of Dermatology, Nara Medical University, Nara, Japan.
Plast Reconstr Surg Glob Open. 2023 Jul 17;11(7):e5116. doi: 10.1097/GOX.0000000000005116. eCollection 2023 Jul.
Chronic expanding hematoma (CEH) is a rare type of hematoma that expands slowly and continuously without compromising coagulation. Its etiology is often unknown. However, we experienced a rare case of CEH, in which an epidermal cyst was thought to be the cause. A 57-year-old man had developed a painless soft-tissue tumor in his left buttock 45 years earlier, which slowly grew to 11 cm in diameter. Preoperative magnetic resonance imaging suggested a large cyst containing several masses. Surgery revealed a hematoma and keratin debris surrounded by a white fibrous cyst wall and a fibrous nodule measuring 4 cm in diameter. On histopathological examination of the white fibrous wall, an epidermal component was observed contralateral to the superficial punctum, but the epidermal component was absent from most of the wall, including the fibrous nodule. Based on a pathological examination, the CEH was suggested to have been caused by partial rupturing and inflammation of an epidermal cyst. To the best of our knowledge, there are no reports of epidermal cysts causing CEH. In addition, the large fibrous nodule protruding from the CEH cyst wall was considered to be rare. This was considered to be a rare CEH that may have originated from an epidermal cyst.
慢性扩展性血肿（CEH）是一种罕见的血肿类型，其缓慢且持续扩展，凝血功能不受影响。其病因通常不明。然而，我们遇到了一例罕见的CEH病例，认为表皮样囊肿是其病因。一名57岁男性45年前在左臀部出现了一个无痛性软组织肿瘤，缓慢生长至直径达11厘米。术前磁共振成像显示一个大囊肿，内有多个肿块。手术发现一个血肿和角质碎屑，周围是白色纤维性囊肿壁和一个直径4厘米的纤维结节。对白色纤维壁进行组织病理学检查时，在浅表小孔对侧观察到表皮成分，但在包括纤维结节在内的大部分囊壁中未发现表皮成分。根据病理检查，提示该CEH是由表皮样囊肿的部分破裂和炎症引起的。据我们所知，尚无表皮样囊肿导致CEH的报道。此外，从CEH囊肿壁突出的大纤维结节被认为很罕见。这被认为是一例可能起源于表皮样囊肿的罕见CEH。
