Hemophilic Pseudotumors: Diagnosis and Management

Prevention is essential for avoiding the complications of muscle hematomas (pseudotumors, compartment syndromesand peripheral nerve lesions) in hemophilic patients. This is achieved through early diagnosis of muscle hematomasand proper long-term hematological treatment until they have resolved (confirmed by image studies). Ultrasound-guidedpercutaneous drainage could be beneficial in terms of achieving better and faster symptom relief. When suspectinga hemophilic pseudotumor, biopsy will help us confirm the diagnosis and rule out true tumors (chondrosarcoma,liposarcoma, synovial sarcoma) that sometimes mimic hemophilic pseudotumor. Surgical removal of hemophilicpseudotumor is the best solution. As alternatives, there are curettage and filling with cancellous bone and radiotherapy(when surgery is contraindicated). Preoperative arterial embolization (ideally 2 weeks before surgery) helps controlintraoperative bleeding during surgery for giant pelvic pseudotumors.Level of evidence: III