Cranial hemophilic pseudotumor

Case report

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✓ Hemophilic pseudotumor is a rare complication of hemophilia occurring in 1% to 2% of individuals with a severe factor VIII or IX deficiency. This pseudotumor has been defined as a progressive cystic swelling involving muscle that is produced by recurrent hemorrhage and may be accompanied by roentgenographic evidence of bone involvement. The case is presented of a 12-month-old child with mild factor VIII deficiency (10% of normal factor VIII activity), who developed a pseudotumor of the skull.

Article Information

Address reprint requests to: Don Horton, M.D., Division of Neurosurgery, University of Oklahoma Health Science Center, P.O. Box 26901, Oklahoma City, Oklahoma 73190.

© AANS, except where prohibited by US copyright law.

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Figures

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    Skull x-ray film, lateral view, demonstrating lytic defects in the right parietal bone.

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    Computerized tomography scan, axial view, without contrast enhancement, showing a hyperdense subgaleal and epidural mass lesion.

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    Magnetic resonance T2-weighted axial image (TR 2000 msec, TE 80 msec) revealing two epidural masses. The smaller anterior mass has evidence of extracellular methemoglobin (high signal intensity). The posterior mass contains both extracellular methemoglobin, intracellular methemoglobin (intermediate signal intensity), and deoxyhemoglobin (low signal intensity). The low signal intensity around the periphery of the lesions is secondary to hemosiderin deposition.

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    Intraoperative photograph showing the lytic bone lesion and the pseudotumor.

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