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PERCUTANEOUS TREATMENT OF HEMOPHILIC PSEUDOTUMORS



Abstract

Purpose of the study: Hemophilic pseudotumor is actually an extended encapsulated hematoma which produces clinical symptoms related to its anatomic position. It is more a clinical entity than a pathological lesion. From 1990, precutaneous aspiration was proposed for significant cysts and pseudotumors treated at the Mariano R. Castex Institute. After aspiration, the cavity was filled with a bone graft for larger tumors or with spongostan or fibrin glue for smaller defects. The pseudocapsule was not removed. We report here results obtained in 17 patients.

Material and results: The 17 patients (all males) presented 19 cysts, mean age 21 years. All had hemophilia (16 A, 1 B), five were HIV-positive, nine were seropositive for hepatitis C and two presented inhibitors. All patients received coagulation factors. One patient died from histoplasmosis. Cure and successful filling of the bone defect was achieved in 15 patients. Revision for conventional resection was required in one case of recurrence.

Discussion: Percutaneous aspiration is a minimally invasive method which enables restoration of the bone tissue. We have not observed any difference between HIV-positive and HIV-negative patients.

Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.