Outcome of surgical management of hemophilic pseudotumor: Review of 9 Cases from single-center

Abstract

Background: Pseudotumours are a rare and serious complication of haemophilia, A slowly growing pseudotumour frequently destroys structures of bone and soft tissues. Surgical resection is the primary method for treatment of proximal pseudotumours. The purpose of this retrospective study was to evaluate the operative methods and clinical results of surgical treatment for those rare cases.Methods: We reviewed nine patients with hemophilic pseudotumours, who received surgical resection treatment in our hospital. The age range was 20-51 years. All operations were performed by one group surgeons. The method of operation depends on the origin and the extent of pseudotumor involvement. With the supplementary of recombinant coagulation factor VIII, six cases received complete resection; one received cytoreduction surgery as the pseudotumor closing to iliac vessel and nerve; two cases received complete resection and construction as bone destruction. Factor substitution was maintained for 14 days. Results: In our series, the average intraoperative blood loss volume was 710±35 ml(range ,240-2100ml). Six patients received blood transfusion during perioperative period. All wounds healed smoothly, no infection or chronic sinus formation. There is no iatrogenic vascular nerve injury in our series. Complete follow-up was performed in all patients. Mean follow-up duration was 14.5months (range, 6–26months). One patient with pseudotumor in the thigh had a recurrence of one year after operation, then secondary operation was performed, Conclusions: Surgical resection for haemophilic pseudotumours is an effctive and safe method . The choice of surgical procedure must be individualized according to the localization and the progress of pseudotumor. However, as relatively few cases and shorter follow-up time in our series. The long-term effects of these patients need further follow-up.