Hayashi Daiki, Ose Naoko, Nagata Hideki, Morii Eiichi, Shintani Yasushi
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, JPN.
Department of Pathology, Osaka University Graduate School of Medicine, Suita, JPN.
Cureus. 2025 Mar 29;17(3):e81444. doi: 10.7759/cureus.81444. eCollection 2025 Mar.
Chronic expanding hematoma (CEH) is a late complication of extraperiosteal paraffin plombage. Various late complications have been reported with this historical procedure, including expanding hematoma, paraffinoma, blood specimens complicating chronic empyema, and malignant tumors. A 75-year-old male presented with left-sided lateral chest pain. Fifty years prior, he had undergone a left upper lobectomy with extraperiosteal paraffin plombage for pulmonary tuberculosis. Three years before the current presentation, he had been admitted to another hospital with fever. At that time, a chest computed tomography (CT) scan showed the expanding plombage and a mass in the plombage. Upon referral to our institute, contrast-enhanced CT showed strong enhancement of part of the mass, and a CEH was suspected. The paraffin and hematoma were surgically removed. Pathological diagnosis was a CEH. Plombaged paraffin can lead to both malignant and benign complications even decades after the initial procedure. Surgical excision should be considered in symptomatic cases or when there is an expanding mass in the plombage space.
慢性扩张性血肿（CEH）是骨膜外石蜡填充术的一种晚期并发症。关于这一历史悠久的手术，已报道了多种晚期并发症，包括扩张性血肿、石蜡瘤、使慢性脓胸复杂化的血标本以及恶性肿瘤。一名75岁男性出现左侧胸痛。50年前，他因肺结核接受了左上肺叶切除术并进行了骨膜外石蜡填充术。在本次就诊前三年，他因发热入住另一家医院。当时，胸部计算机断层扫描（CT）显示填充材料扩张且填充区内有一肿块。转诊至我院后，增强CT显示肿块部分有强烈强化，怀疑为CEH。手术切除了石蜡和血肿。病理诊断为CEH。即使在初次手术后数十年，填充的石蜡也可能导致恶性和良性并发症。对于有症状的病例或填充区内有扩张性肿块时，应考虑手术切除。
