Subject(s)
Astrocytoma/pathology , Brain Neoplasms/pathology , Neoplasms, Second Primary/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Astrocytoma/surgery , Brain Neoplasms/surgery , Child, Preschool , Humans , Magnetic Resonance Imaging , Male , Neoplasms, Second Primary/therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapySubject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Coagulants/therapeutic use , Disseminated Intravascular Coagulation/drug therapy , Factor VIIa/therapeutic use , Hemorrhage/drug therapy , Neuroblastoma/drug therapy , Disseminated Intravascular Coagulation/chemically induced , Hemorrhage/chemically induced , Humans , Infant , Male , Recombinant Proteins/therapeutic use , Time Factors , Treatment OutcomeABSTRACT
Hemophilic pseudotumor is an uncommon complication seen in approximately 1-2% of patients with severe hemophilia. Hemophilic pseudotumors are distinguished into two subdivisions based on location, proximal or distal. Plain x-rays and CT are useful in diagnosis, but MR imaging is the diagnostic test of choice because of its sensitivity to the various blood products. The choice of therapy depends on many parameters, such as the size of the tumor, the age of the patient, and the relation with underlying organs. In most cases of asymptomatic hemophilic pseudotumor, conservative treatment with administration of missing factor as well as immobilization is recommended. The authors describe a 13-year-old boy with severe hemophilia A, who presented with a tibial pseudotumor a few months after an injury. He was conservatively treated for a long period, with daily administration of recombinant factor VIII. His clinical condition improved shortly after therapy induction, but radiological improvement has been moderate. Case history, imaging findings, and therapeutic options are discussed.
