Abstract
Hemophilic pseudotumor involving the spine is extremely uncommon and presents a challenging problem. Preoperative planning, angiography, intra and perioperative monitoring with factor VIII cover and postoperative care for hemophilic pseudotumor is vital. Recognition of the artery of Adamkiewicz in the thoracolumbar junction helps to avoid intraoperative neurological injury. We report the case of a 26-year-old male patient with hemophilia A, who presented with a massive pseudotumor involving the first lumbar vertebra and the left iliopsoas. Preoperative angiography revealed the artery of Adamkiewicz arising from the left first lumbar segmental artery. Excision of pseudotumor was successfully carried out with additional spinal stabilization. At 2 years followup, there was no recurrence and the patient was well stabilized with a satisfactory functional status. Surgical excision gives satisfactory outcome in such cases.
Similar content being viewed by others
References
Ahlberg AK. On the natural history of hemophilic pseudotumor. J Bone Joint Surg Am 1975;57:1133–6.
Heim M, Martinowitz U. Pseudotumours in patients with haemophilia. In: Lee CA, Berntorp EE, Hoots WK, Aledort LM, editors. Textbook of Hemophilia. Oxford, UK: Blackwell Publishing Ltd.:2007.
Starker L. Knochenusur durch ein hamophiles subperiostales hamatom. Mitt Med Chir 1918;31:381.
Steel WM, Duthie RB, O’Connor BT. Haemophilic cysts. Report of five cases. J Bone Joint Surg Br 1969;51:614–26.
Gilbert MS. The hemophilic pseudotumor. Prog Clin Biol Res 1990;324:257–62.
Rodriguez-Merchan EC. The haemophilic pseudotumour. Haemophilia 2002;8:12–6.
Heeg M, Smit WM, van der Meer J, van Horn JR. Excision of a haemophilic pseudotumour of the ilium, complicated by fistulation. Haemophilia 1998;4:132–5.
Panthee N, Ono M. Spinal cord injury following thoracic and thoracoabdominal aortic repairs. Asian Cardiovasc Thorac Ann 2014;[Epub ahead of print].
Liu SS, White WL, Johnson PC, Gauntt C. Hemophilic pseudotumor of the spinal canal. Case report. J Neurosurg 1988;69:624–7.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nachimuthu, G., Arockiaraj, J.S.V., Krishnan, V. et al. Hemophilic pseudotumor of the first lumbar vertebra. IJOO 48, 617–620 (2014). https://doi.org/10.4103/0019-5413.144238
Published:
Issue Date:
DOI: https://doi.org/10.4103/0019-5413.144238