Abstract
BackgroundChronic expanding hematoma is a rare condition that develops after surgery, trauma, or injury. It can also develop at any location in the body in the absence of trauma. Clinical findings and various diagnostic imaging modalities can aid in the differential diagnosis of this condition. In general, hematomas are naturally reabsorbed and rarely cause serious problems. However, hematomas that develop slowly without a history of trauma, surgery, or bleeding disorders could be difficult to differentiate from soft tissue neoplasms. In the present case, we describe a patient, without any history or physical evidence of trauma, who exhibited a large chronic expanding hematoma in the retroperitoneal space that resulted in hydronephrosis because of the pressure exerted on the left ureter.Case presentationA 69-year-old man presented to our hospital with a swollen lesion in the left flank. A mass, 19 cm in diameter, was detected in the retroperitoneal space by computed tomography. We suspected the presence of a chronic expanding hematoma, soft tissue tumor, or left renal artery aneurysm. Surgical treatment was performed. However, postoperative histopathological examination indicated that the mass was a nonmalignant chronic expanding hematoma. No recurrence was observed during a 2-year follow-up period.ConclusionIn patients without a history of trauma who present slowly growing masses, the differential diagnosis should include chronic expanding hematoma in addition to cysts and soft tissue tumors. Moreover, the use of magnetic resonance imaging and computed tomography is essential to differentiate between chronic expanding hematoma and soft tissue tumors.
Highlights
Chronic expanding hematoma is a rare condition that develops after surgery, trauma, or injury
We describe a case of chronic expanding hematomas (CEH) developing in the retroperitoneal space that was associated with hydronephrosis
CEH is a type of hematoma that is most commonly caused by trauma, and has certain other etiologies such as hemorrhagic disorder
Summary
We reported the case of a patient with a huge CEH located in the retroperitoneal space that resulted in hydronephrosis. MRI may be useful for differentiating between CEH and malignant soft tissue tumors. Complete removal of the CEH resulted in resolution of hydronephrosis and no recurrence of CEH at the 2-year follow-up. Consent Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. Competing interests The authors declare that they have no competing interests. Authors’ contributions TK was responsible for acquisition of data, drafting of manuscript and preparation of the figures and table. MH and MN operated the patient and revised manuscript. TS and KS was responsible for critical revision of the manuscript. All authors read and approved the final manuscript
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