High-grade sarcomas mimicking traumatic intramuscular hematomas: a report of three cases

We reported on three patients with high-grade soft-tissue sarcomas mimicking traumatic intramuscular hematomas. Patients had an episode of trauma to the extremity, and after initial clinical and imaging evaluations they were considered to have muscular hematomas. The lesions increased in size over time, leading to further evaluations that demonstrated the actual diagnosis. We conducted a retrospective review of the clinical findings, magnetic resonance images, and computed tomography scans to assess characteristics that will help in the differential diagnosis. We conclude that intramuscular hematomas following trauma should be approached with a high degree of clinical suspicion. MRI analysis can be used as an important diagnostic tool, but the results must be seen in the context of the clinical history. MRI is not sensitive or specific enough to rule out malignancy. The diagnosis of a high-grade sarcoma must be considered in these patients and any doubt should be resolved with a biopsy.