Temporal Evolution of a Chronic Expanding Organizing Hematoma on MRI, Including Functional MR Imaging Techniques: a Case Report

Chronic expanding organizing hematoma (CEH), also known as chronic expanding hematoma, is a benign condition in which a hematoma does not undergo resorption, but rather it persists or even expands slowly. The term was first coined by Reid et al. (1), and the authors defined CEHs as hematomas that increase in size for over 1 month after the causative event. The clinical importance of this lesion arises from the fact that it often mimics malignant soft tissue neoplasms, both clinically and radiologically (2-4). Numerous studies have described the features of CEH on conventional MRI (2-4), but reports that present the findings on diffusion-weighted imaging (DWI) (3) and dynamic contrast-enhanced (DCE) imaging are rare. Herein, we illustrate an unusual case of CEH in which we could obtain regular, serial MRI scans, including DWI and DCE, for over 2 years. This case demonstrates the added value of DWI and DCE for differentiating CEH This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received: December 22, 2016 Revised: February 25, 2017 Accepted: March 6, 2017

[1]  K. Choi,et al.  Short-term follow-up MRI after unplanned resection of malignant soft-tissue tumours; quantitative measurements on dynamic contrast enhanced and diffusion-weighted MR images. , 2016, The British journal of radiology.

[2]  J. Ahn,et al.  Growing Organized Hematomas Following Gamma Knife Radiosurgery for Cerebral Arteriovenous Malformation : Five Cases of Surgical Excision , 2015, Journal of Korean Neurosurgical Society.

[3]  S. Tirumani,et al.  Comparison of ADC values in different malignancies of the skeletal musculature: a multicentric analysis , 2015, Skeletal Radiology.

[4]  Y. Tanzawa,et al.  Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor: a case report , 2014, Journal of Medical Case Reports.

[5]  Michael R. Aro,et al.  Detection of soft-tissue sarcoma recurrence: added value of functional MR imaging techniques at 3.0 T. , 2014, Radiology.

[6]  A. Fedenko,et al.  A Comparison of Fine-needle Aspiration, Core Biopsy, and Surgical Biopsy in the Diagnosis of Extremity Soft Tissue Masses , 2010, Clinical orthopaedics and related research.

[7]  Y. Yamashita,et al.  Ability of diffusion‐weighted imaging for the differential diagnosis between chronic expanding hematomas and malignant soft tissue tumors , 2008, Journal of magnetic resonance imaging : JMRI.

[8]  A. Nihal,et al.  Chronic haematoma or soft-tissue neoplasm? A diagnostic dilemma , 2004, Archives of Orthopaedic and Trauma Surgery.

[9]  Toshitaka Nakamura,et al.  The radiological findings in chronic expanding hematoma , 1999, Skeletal Radiology.

[10]  M. C. Park,et al.  Chronic expanding hematomas. A clinicopathologic entity. , 1980, JAMA.