Guo EQ, Yang XD, Lu HR. Tumor-like disorder of the brachial plexus region in a patient with hemophilia: A case report. World J Clin Cases 2022; 10(17): 5910-5915 [PMID: 35979120 DOI: 10.12998/wjcc.v10.i17.5910]
Corresponding Author of This Article
Hong-Rui Lu, MD, Doctor, Center for Plastic and Reconstructive Surgery, Department of Hand and Reconstructive Surgery, Zhejiang Provincial People’s Hospital, Affiliated People's Hospital, Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. guoenqi@hmc.edu.cn
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2022; 10(17): 5910-5915 Published online Jun 16, 2022. 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, Xiao-Dong Yang, Hong-Rui Lu
En-Qi Guo, Xiao-Dong Yang, Hong-Rui Lu, Center for Plastic and Reconstructive Surgery, Department of Hand and Reconstructive Surgery, Zhejiang Provincial People’s Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Author contributions: Yang XD and Lu HR diagnosed the patient, provided surgical treatment, acquired clinical data, revised and reviewed the manuscript for the final publication; Guo EQ reviewed the literature, and drafted the manuscript; all authors read and approved the final manuscript.
Supported bythe Foundation of Science and Technology Department of Zhejiang Province, No. LGF19H060010; and the Foundation of Health and Family Planning Commission of Zhejiang Province, No. 2021KY445.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Rui Lu, MD, Doctor, Center for Plastic and Reconstructive Surgery, Department of Hand and Reconstructive Surgery, Zhejiang Provincial People’s Hospital, Affiliated People's Hospital, Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. guoenqi@hmc.edu.cn
Received: January 16, 2022 Peer-review started: January 16, 2022 First decision: March 16, 2022 Revised: March 25, 2022 Accepted: April 9, 2022 Article in press: April 9, 2022 Published online: June 16, 2022 Processing time: 143 Days and 18.8 Hours
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.
Core Tip: 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. We presented our experience with successful surgical management of a brachial plexus tumor-like disorder, which was eventually proved to be an extrinsic muscular hematoma in the vicinity of the plexus. Early surgical intervention is crucial and it seems to be an essential precondition for recovery of nerve function.
