Acquired Hemophilia A Simulating Retropharyngeal Abscess: Importance of Differential Diagnosis of Neck Masses before Surgery

Abstract

The coexistence of acquired hemophilia A with a secondary retropharyngeal hematoma is an extremely unusual condition with important clinical implications. The purpose of this paper is to present a case involving a patient whose first clinical manifestation, namely dysphagia, along with specific clinical examination and imaging findings, led to an incorrect initial diagnosis of a retropharyngeal abscess. However, performance of a more thorough clinical examination led to the correct diagnosis of a hematoma secondary to acquired hemophilia A. This allowed surgery to be avoided in a patient at a high risk of bleeding. Conclusions: Acute neck masses require meticulous differential diagnosis assessing the possible presence of various causative systemic diseases before the most appropriate therapy can be determined.