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Haemophilia ; 26(4): 694-700, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32530103

ABSTRACT

INTRODUCTION: Haemophilic pseudotumour (HP) is an encapsulated haematoma in patients with haemophilia (PWH) which has a tendency to progress and produce clinical symptoms related to its anatomical location. AIM: To show the experience of one surgeon who has been using mini-invasive technique to treat pseudotumours of limbs in PWH with and without inhibitors at one centre for 28 years. MATERIALS AND METHODS: Thirty-three patients with 39 HP were treated. All patients had haemophilia A. Twenty-four patients had no inhibitors (72.8%), and 9 had inhibitors (27.2%). The mean follow-up was 16 years (1-25). All patients had x-rays and MRIs. All of them received Buenos Aires protocol as conservative treatment for 6 weeks. MRIs were repeated after 6 weeks' treatment to assess response to treatment. Surgery was performed in patients who did not respond to conservative treatment. RESULTS: After Buenos Aires protocol, four pseudotumours did not shrink (10.24%), 33 (84.61%) shrank, and two (5.12%) healed. Thirty-seven pseudotumours had surgery, 35 pseudotumours (94.59%) healed with minimally invasive treatment, and two did not heal (5.41%). No infection was observed with this treatment. The mortality rate for the series was 0%. CONCLUSION: The minimally invasive treatment of pseudotumours was effective in 95% of the cases and resulted in no mortality in this series after 28 years.


Subject(s)
Extremities/pathology , Hematoma/surgery , Hemophilia A/pathology , Minimally Invasive Surgical Procedures/methods , Adolescent , Adult , Child , Coagulants/administration & dosage , Coagulants/therapeutic use , Conservative Treatment/methods , Extremities/diagnostic imaging , Factor VIIa/administration & dosage , Factor VIIa/therapeutic use , Hematoma/drug therapy , Hemophilia A/complications , Humans , Infusions, Intravenous , Magnetic Resonance Imaging/methods , Middle Aged , Radiography/methods , Soft Tissue Neoplasms/diagnostic imaging , Soft Tissue Neoplasms/pathology , Treatment Outcome , Young Adult
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