Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor: A case report

Yusuke Nishida, Eisuke Kobayashi, Daisuke Kubota, Nokitaka Setsu, Koichi Ogura, Yoshikazu Tanzawa, Fumihiko Nakatani, Yoshiharu Kato, Hirokazu Chuman, Akira Kawai

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Chronic expanding hematoma is a rare persistent hematoma that can sometimes be misdiagnosed as a malignant tumor due to its clinical and radiological features. Case presentation: A 42-year-old Japanese man with a large mass in his leg, suggestive of malignancy, presented to our hospital. He had been aware of the leg swelling for the last eight years. A magnetic resonance imaging scan demonstrated a large mass with two components. One was a large, well-defined cystic mass (13×9cm) showing high intensity on T1-and T2-weighted images, and the other was a solid mass (3.5×2.5cm, adjacent to the large mass) with high intensity on T1-weighted images. Two-[18F]fluoro-2 deoxy-D glucose positron emission tomography images revealed increased uptake with a maximum standardized uptake value of 15.8 in the solid mass. As these findings were considered suggestive of hematoma associated with a malignant lesion, an open biopsy was performed. A pathological examination demonstrated a hematoma with xanthogranuloma, and no malignant cells were evident. Therefore, we resected the tumor including both components, and the histological diagnosis was chronic expanding hematoma. Clinical diagnosis based on 2-[18F]fluoro-2 deoxy-D glucose uptake is sometimes limited by the fact that 2-[18F]fluoro-2 deoxy-D glucose is taken up by not only malignant tumor cells but also macrophages and tissues with granulation or inflammation. Conclusions: Significantly increased standardized uptake value in the peripheral rim of the lesion on 2-[18F]fluoro-2 deoxy-D glucose positron emission tomography imaging, mimicking a soft tissue sarcoma, should be recognized as a potential diagnostic pitfall in cases of chronic expanding hematoma.

Original languageEnglish
Article number349
JournalJournal of Medical Case Reports
Volume8
Issue number1
DOIs
Publication statusPublished - Jan 1 2014

Fingerprint

Fluorodeoxyglucose F18
Hematoma
Positron-Emission Tomography
Neoplasms
Leg
Granulation Tissue
Deoxyglucose
Diagnostic Errors
Sarcoma
Macrophages
Magnetic Resonance Imaging
Inflammation
Biopsy

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor : A case report. / Nishida, Yusuke; Kobayashi, Eisuke; Kubota, Daisuke; Setsu, Nokitaka; Ogura, Koichi; Tanzawa, Yoshikazu; Nakatani, Fumihiko; Kato, Yoshiharu; Chuman, Hirokazu; Kawai, Akira.

In: Journal of Medical Case Reports, Vol. 8, No. 1, 349, 01.01.2014.

Research output: Contribution to journalArticle

Nishida, Yusuke ; Kobayashi, Eisuke ; Kubota, Daisuke ; Setsu, Nokitaka ; Ogura, Koichi ; Tanzawa, Yoshikazu ; Nakatani, Fumihiko ; Kato, Yoshiharu ; Chuman, Hirokazu ; Kawai, Akira. / Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor : A case report. In: Journal of Medical Case Reports. 2014 ; Vol. 8, No. 1.
@article{a035e242f28b475eba4a3298a3fae5f9,
title = "Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor: A case report",
abstract = "Introduction: Chronic expanding hematoma is a rare persistent hematoma that can sometimes be misdiagnosed as a malignant tumor due to its clinical and radiological features. Case presentation: A 42-year-old Japanese man with a large mass in his leg, suggestive of malignancy, presented to our hospital. He had been aware of the leg swelling for the last eight years. A magnetic resonance imaging scan demonstrated a large mass with two components. One was a large, well-defined cystic mass (13×9cm) showing high intensity on T1-and T2-weighted images, and the other was a solid mass (3.5×2.5cm, adjacent to the large mass) with high intensity on T1-weighted images. Two-[18F]fluoro-2 deoxy-D glucose positron emission tomography images revealed increased uptake with a maximum standardized uptake value of 15.8 in the solid mass. As these findings were considered suggestive of hematoma associated with a malignant lesion, an open biopsy was performed. A pathological examination demonstrated a hematoma with xanthogranuloma, and no malignant cells were evident. Therefore, we resected the tumor including both components, and the histological diagnosis was chronic expanding hematoma. Clinical diagnosis based on 2-[18F]fluoro-2 deoxy-D glucose uptake is sometimes limited by the fact that 2-[18F]fluoro-2 deoxy-D glucose is taken up by not only malignant tumor cells but also macrophages and tissues with granulation or inflammation. Conclusions: Significantly increased standardized uptake value in the peripheral rim of the lesion on 2-[18F]fluoro-2 deoxy-D glucose positron emission tomography imaging, mimicking a soft tissue sarcoma, should be recognized as a potential diagnostic pitfall in cases of chronic expanding hematoma.",
author = "Yusuke Nishida and Eisuke Kobayashi and Daisuke Kubota and Nokitaka Setsu and Koichi Ogura and Yoshikazu Tanzawa and Fumihiko Nakatani and Yoshiharu Kato and Hirokazu Chuman and Akira Kawai",
year = "2014",
month = "1",
day = "1",
doi = "10.1186/1752-1947-8-349",
language = "English",
volume = "8",
journal = "Journal of Medical Case Reports",
issn = "1752-1947",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor

T2 - A case report

AU - Nishida, Yusuke

AU - Kobayashi, Eisuke

AU - Kubota, Daisuke

AU - Setsu, Nokitaka

AU - Ogura, Koichi

AU - Tanzawa, Yoshikazu

AU - Nakatani, Fumihiko

AU - Kato, Yoshiharu

AU - Chuman, Hirokazu

AU - Kawai, Akira

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Introduction: Chronic expanding hematoma is a rare persistent hematoma that can sometimes be misdiagnosed as a malignant tumor due to its clinical and radiological features. Case presentation: A 42-year-old Japanese man with a large mass in his leg, suggestive of malignancy, presented to our hospital. He had been aware of the leg swelling for the last eight years. A magnetic resonance imaging scan demonstrated a large mass with two components. One was a large, well-defined cystic mass (13×9cm) showing high intensity on T1-and T2-weighted images, and the other was a solid mass (3.5×2.5cm, adjacent to the large mass) with high intensity on T1-weighted images. Two-[18F]fluoro-2 deoxy-D glucose positron emission tomography images revealed increased uptake with a maximum standardized uptake value of 15.8 in the solid mass. As these findings were considered suggestive of hematoma associated with a malignant lesion, an open biopsy was performed. A pathological examination demonstrated a hematoma with xanthogranuloma, and no malignant cells were evident. Therefore, we resected the tumor including both components, and the histological diagnosis was chronic expanding hematoma. Clinical diagnosis based on 2-[18F]fluoro-2 deoxy-D glucose uptake is sometimes limited by the fact that 2-[18F]fluoro-2 deoxy-D glucose is taken up by not only malignant tumor cells but also macrophages and tissues with granulation or inflammation. Conclusions: Significantly increased standardized uptake value in the peripheral rim of the lesion on 2-[18F]fluoro-2 deoxy-D glucose positron emission tomography imaging, mimicking a soft tissue sarcoma, should be recognized as a potential diagnostic pitfall in cases of chronic expanding hematoma.

AB - Introduction: Chronic expanding hematoma is a rare persistent hematoma that can sometimes be misdiagnosed as a malignant tumor due to its clinical and radiological features. Case presentation: A 42-year-old Japanese man with a large mass in his leg, suggestive of malignancy, presented to our hospital. He had been aware of the leg swelling for the last eight years. A magnetic resonance imaging scan demonstrated a large mass with two components. One was a large, well-defined cystic mass (13×9cm) showing high intensity on T1-and T2-weighted images, and the other was a solid mass (3.5×2.5cm, adjacent to the large mass) with high intensity on T1-weighted images. Two-[18F]fluoro-2 deoxy-D glucose positron emission tomography images revealed increased uptake with a maximum standardized uptake value of 15.8 in the solid mass. As these findings were considered suggestive of hematoma associated with a malignant lesion, an open biopsy was performed. A pathological examination demonstrated a hematoma with xanthogranuloma, and no malignant cells were evident. Therefore, we resected the tumor including both components, and the histological diagnosis was chronic expanding hematoma. Clinical diagnosis based on 2-[18F]fluoro-2 deoxy-D glucose uptake is sometimes limited by the fact that 2-[18F]fluoro-2 deoxy-D glucose is taken up by not only malignant tumor cells but also macrophages and tissues with granulation or inflammation. Conclusions: Significantly increased standardized uptake value in the peripheral rim of the lesion on 2-[18F]fluoro-2 deoxy-D glucose positron emission tomography imaging, mimicking a soft tissue sarcoma, should be recognized as a potential diagnostic pitfall in cases of chronic expanding hematoma.

UR - http://www.scopus.com/inward/record.url?scp=84927170740&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927170740&partnerID=8YFLogxK

U2 - 10.1186/1752-1947-8-349

DO - 10.1186/1752-1947-8-349

M3 - Article

C2 - 25335527

AN - SCOPUS:84927170740

VL - 8

JO - Journal of Medical Case Reports

JF - Journal of Medical Case Reports

SN - 1752-1947

IS - 1

M1 - 349

ER -