Hemophilic Pseudotumor in the Leg: A Case Report and Literature Review

Background: One of the less common complications of hemophilia is a hemophilic pseudotumor, which is an encapsulated mass of necrosed tissue and clotted blood that develops from repeated bleeding. These pseudotumor are rarely detected in the leg and are primarily prevalent in the pelvis and mandible. Case report: A 34-year-old patient with history of hemophilia came with complaints of pain on the left knee to the left calf. Physical examination revealed multiple skin blister on cutis regio cruris sinistra, pain during tibiotalar mobilization, and limited support. Images showed intramuscular hematoma in medial and lateral head gastrocnemius sinistra which forces the left soleus anteriorly. In view of these findings, the patient underwent biopsy with favorable postoperative outcomes. Discussion: This hematological condition tends to be self-limited and reabsorbed, favoring spontaneous bleeding or minimal trauma. Following the initial hemarthrosis episode, the condition may become chronic or recurring, resulting in gradual cartilage damage and synovial membrane enlargement. Because pseudotumor can occur in places like the leg where prompt identification is impossible, their presentation necessitates a high degree of suspicion. Because there was a lack of soft tissue in the perilesional area, the pseudotumor presentation described here showed early clinical evidence. It is important to note that the most effective treatment is preventing musculoskeletal bleeding with prophylactic coagulation factor delivery. Conclusion: In order to give appropriate treatment, it is crucial to identify the potential for missing hemophilic pseudotumor at the time of initial diagnosis. Keywords: hemophilia, pseudotumor, arthrosis, leg