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KMID : 0613320080140020163
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Journal of the Korean Bone and Joint Tumor Soceity
2008 Volume.14 No. 2 p.163 ~ p.171
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Soft Tissue Sarcomas Presented with Hematoma
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Chung Yang-Guk
Kang Yong-Koo
Park Won-Jong
Rhee Seung-Koo
Lee An-Hi
Park Jeong-Mi
Cho Hyun-Min
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Abstract
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Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed.
Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles.
Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases.
Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.
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KEYWORD
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Soft tissue sarcoma, Hematoma, Clinical suspicion, MR image
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