title: Bilateral cranial hemophilic pseudotumor.
abstract: Hemophilic pseudotumor is a rare but well-known complication of hemophilia manifesting as recurrent hemorrhage and progressive enlargement of hematoma. A patient with severe hemophilia has 1% to 2% chance to develop pseudotumor. The chronic pressure of osseous hemorrhage usually results in bone destruction or resorption. Cranial hemophilic pseudotumors are extremely rare, with only 7 reported cases associated with mild or moderate factor VIII or IX deficiency. A 42-year-old man with a mild factor VIII deficiency developed a pseudotumor of the bilateral skull. Computed tomography and magnetic resonance imaging revealed an extra-axial lesion with bone destruction, and signal changes are consistent with chronic hemorrhage. With adequate factor-deficient replacement therapy, surgical removal was performed. Histologic examination disclosed old blood coagulum. No recurrence was observed in 3 years of follow-up. Cranial hemophilic pseudotumor is extremely rare, and with adequate factor-deficient replacement therapy, surgical management is a safe and effective way for cranial hemophilic pseudotumor treatment.
authors.affiliation: From the Department of Neurosurgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou Zhejiang Province, People's Republic of China.
authors.forename: Qingsheng
authors.initials: Q
authors.lastname: Xu
authors.forename: Pan
authors.initials: P
authors.lastname: Wu
authors.forename: Yiping
authors.initials: Y
authors.lastname: Feng
mesh_terms: D000328:Adult; D001847:Bone Diseases / Q000209:etiology* / Q000601:surgery; D003029:Coagulants / Q000627:therapeutic use; D005169:Factor VIII / Q000627:therapeutic use; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology* / Q000601:surgery; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009777:Occipital Bone / Q000473:pathology*; D010014:Osteolysis / Q000209:etiology / Q000601:surgery; D010294:Parietal Bone / Q000473:pathology*; D011312:Pressure; D012008:Recurrence; D014057:Tomography, X-Ray Computed
chemical_list: D003029:Coagulants; D005169:Factor VIII