Giant spontaneous hematoma of the thoracic wall in a patient with REST syndrome.
We report on a 56-year-old patient with systemic sclerosis of one and a half year's duration who was admitted with an acute soft tissue swelling over the left scapula and a marked reduction of joint mobility of the left shoulder. Over the following days, the swelling extended distally and a hemorrhagic discoloration developed, reaching down to the scrotum. Nuclear magnetic resonance imaging revealed a giant intermuscular hematoma between the serratus anterior and the costal muscles. This is the first report of an extensive spontaneous hematoma of the thoracic wall in a patient with progressive systemic sclerosis. Its development and unusual localization may be explained by both the underlying systemic sclerosis and the patient's previous profession as a trapeze artist. Hemorrhagic complications of systemic sclerosis are rare but should be watched for in these patients.
Böhm
M
M
Department of Dermatology, University Hospital Rudolf Virchow, Free University, Berlin, Germany.
Haas
N
N
Czarnetzki
B M
BM
D017675:CREST Syndrome / Q000150:complications*; D006406:Hematoma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D013896:Thoracic Diseases / Q000150:complications* / Q000175:diagnosis