Tibial pseudotumor in a child with hemophilia.
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.
Hatzipantelis
Emmanouil S
ES
Hippokration General Hospital of Thessaloniki, 1st Paediatric Department of Aristotle University of Thessaloniki, Thessaloniki, Greece. Chatzipa@med.auth.gr
Athanassiou-Metaxa
Miranda
M
Koussi
Afroditi
A
Tsatra
Ioanna
I
Badouraki
Maria
M
Tsayias
Ioannis
I
Gombakis
Nikolaos
N
D000293:Adolescent; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D005169:Factor VIII / Q000008:administration & dosage; D006467:Hemophilia A / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013977:Tibia / Q000000981:diagnostic imaging*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
C078147:F8 protein, human; D005169:Factor VIII