Massive gluteal mass mimicking sarcoma: Chronic expanding hematoma

Abstract Chronic expanding hematomas (CEH) are rare presentation of hematomas characterized by its long-term persistence and chronic expansion. It had been a challenge for clinicians to differentiate CEH from hemorrhagic neoplasms, both clinically and radiologically. In Case 1, patient was presented with a massive gluteal mass lasting for 5 years. In our diagnostic approach, magnetic resonance imaging and ultrasound-guided biopsy helped us to get the initial impression of the mass and direct the surgical planning. Definitive diagnosis was done by pathological examination. In Case 2, the patient was presented with a intraooseous chronic expanding hematoma of the left ilium. The patient was treated with an endoscopic assisted tumor excision and prolonged drainage to preserve the live quality and function of the patient. After reviewing the related articles, we conclude that when CEH is suspected, especially in presence of history of trauma, early excision remains the gold standard for treatment. From the present researches on the cellular effects of blood breakdown products, we also suggest early intervention of chronic hematomas to avoid chronic expansion and associated bony destruction.