Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
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 by the 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
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, Hematoma, Hemophilia, Surgical intervention, Case report

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.