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Case Reports
. 2022 Jun 16;10(17):5910-5915.
doi: 10.12998/wjcc.v10.i17.5910.

Tumor-like disorder of the brachial plexus region in a patient with hemophilia: A case report

En-Qi Guo  1 , Xiao-Dong Yang  1 , Hong-Rui Lu  2
Affiliations
Case Reports

Tumor-like disorder of the brachial plexus region in a patient with hemophilia: A case report

En-Qi Guo et al. World J Clin Cases. .

Abstract

Background: Various tumors and tumor-like disorders, originating from the neural sheath, as well as other types, may affect the brachial plexus region. Due to the infrequent presentation, brachial plexus palsy caused by spontaneous hematoma in patients with hemophilia might miss the treatment by early surgical decompression and progress to permanent nerve damage.

Case summary: The case reported here was a 30-year-old man with hemophilia, as well as both sensory and motor dysfunction of the left upper extremity. A presumptive diagnosis of brachial plexus tumor was initially made, which was subsequently confirmed to be an organized chronic hematoma rather than a neoplasm. The hemophilia-induced expanding hematoma compressing the brachial plexus was considered to be the main reason for the patient's complaints. The clinical symptoms were alleviated and the involved nerves partially recovered at a follow-up of 1 year.

Conclusion: Early surgical intervention is crucial and it seems to be an essential precondition for recovery of nerve function in brachial plexus lesions.

Keywords: Brachial plexus lesions; Case report; Hematoma; Hemophilia; Surgical intervention.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Magnetic resonance images of the left upper limb. Sagittal and coronal views of T2-weighted images showed a focal mass on left coracobrachialis muscle (white arrow).
Figure 2
Figure 2
Histopathological examination of the resected mass showed inflammatory infiltration with hemosiderin pigments and fibrosis (hematoxylin and eosin stain, × 100).
Figure 3
Figure 3
Intraoperative findings of the patient. A: An organized mass was exposed prior to excision (black arrow); B: Brachial plexus neurolysis was performed after the mass resection; C: The cut surface of the resected specimen indicated an organized chronic hematoma rather than a neoplasm.
Figure 4
Figure 4
A 12 mo follow-up assessment demonstrated definite improvement in the left shoulder abduction, elbow flexion and grip strength after successful surgery.
See this image and copyright information in PMC

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