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Updated: Aug 2, 2025
Primary Culture of Human Vestibular Schwannomas
Published on: July 20, 2014
Ancient Schwannoma with Hemorrhagic Degeneration Causing Chronic Intramuscular Hematoma: A Case Report
Ryan J Giarraputo1, Grace Gilbert2,3, Gord Guo Zhu4
1Cooper Medical School of Rowan University, 401 South Broadway, Camden, New Jersey.
Introduction:
The value of this manuscript is that it highlights a common diagnostic challenge facing orthopedic surgeons, involving the reality that both benign and malignant soft-tissue tumors can present as large cystic masses masquerading as a hematoma. This is the first report of its kind to describe a schwannoma presenting as such a large hematoma in the thigh.
Case Presentation:
A 64-year-old male presented with 2 days of worsening pain over a left posterior thigh mass that was enlarging for 12 years. Imaging demonstrated a cystic mass. 1.8L of serosanguinous fluid was aspirated and cytology was negative for malignancy, suggesting chronic hematoma. The fluid reaccumulated, indicating surgical management. Histopathology revealed a hemorrhagic ancient schwannoma.
Conclusion:
Without history of trauma or anticoagulation, intramuscular hematoma should be a diagnosis of exclusion. Burden of proof is high to rule-out a neoplastic process masquerading as fluid collection. Biopsies should be taken and schwannoma with ancient change and cystic degeneration should be considered.
