An unusual case of pleural-based tumor with life-threatening post-operative complication.

Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
Manoj K GoelAjay Kumar

Abstract

A 57-year-old male presented with hemoptysis of 4 years duration and a gradually increasing pleural mass on chest X-ray. The mass was causing pressure effects on the liver and the lungs. To rule out malignancy, thoracotomy was performed, which revealed large, thick-walled hematoma. Complete excision of mass was performed. Post-operative course was complicated by massive pleural bleeding requiring massive blood transfusions and re-exploratory thoracotomy. Subsequent tests revealed factor IX deficiency and, hence, he was managed with recombinant factor IX concentrate. This case stresses upon the fact that hereditary bleeding disorders may be diagnosed even in late adulthood with atypical presentations such as pseudotumor in pleural space. Moreover, hemophilia B may present with normal APTT levels making the diagnosis even more difficult.

References

Mar 1, 1990·AJR. American Journal of Roentgenology·A N LeungR R Miller
Aug 1, 1995·Pediatrics in Review·B BellM Audet
Jul 27, 2000·American Journal of Hematology·M E O'Dwyer, T G DeLoughery
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Mar 23, 2010·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Chang-Hun ParkSun-Hee Kim

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Citations

Jan 18, 2018·Psychological Medicine·Satu M KumpulainenKatri Räikkönen
Nov 20, 2019·Haemophilia : the Official Journal of the World Federation of Hemophilia·Andrew J DoyleSteve Austin

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Methods Mentioned

BETA
X-ray
biopsy

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