Work

Giant abdominal wall chronic expanding hematoma mimicking malignancy: A rare case of cosmetic concern in a middle-aged woman — case report and literature review

Year: 2025

Type: article

Abstract: INTRODUCTION AND IMPORTANCE: Hematomas typically resolve spontaneously; however, in rare cases, they may progressively enlarge, becoming encapsulated and fibrotic, forming a chronic expanding hematoma (CEH). CEH is a slowly enlarging lesion that may mimic malignancy on imaging, leading to diagnostic uncertainty. This report presents a rare case of a giant CEH of the anterior abdominal wall in a middle-aged woman following blunt abdominal trauma. The case emphasizes the importance of including CEH in the differential diagnosis of large soft-tissue masses and highlights the effectiveness of surgical excision in achieving definitive management. CASE PRESENTATION: A 39-year-old healthy Palestinian female presented with a gradually enlarging, asymptomatic swelling in the lower abdomen, which developed following blunt abdominal trauma two years prior. A contrast-enhanced CT scan revealed a well-defined cystic lesion in the subcutaneous layer of the lower anterior abdominal wall, below the umbilical level. The patient underwent elective surgery, and histopathological analysis of the excised mass confirmed a benign cyst wall with dense fibrosis, chronic inflammation, and foci of hemorrhage. CLINICAL DISCUSSION: CEH has been reported in various anatomical sites, such as the extremities and thoracic cavity, but remains rare in the abdominal wall. Differentiating it from malignant masses can be challenging; however, it should be considered in the differential diagnosis, especially in patients with a history of trauma and no systemic symptoms. Diagnosis relies on imaging findings and is confirmed histologically. CONCLUSION: CEH should be considered in the differential diagnosis of slowly enlarging, cystic abdominal wall masses, particularly in patients with a history of trauma. Accurate diagnosis and timely surgical excision are essential to avoid unnecessary oncologic interventions.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.111742

Authors: Raed Alshawawreh, Fatima Amer, Sajeda Nawajaa, Samer Abdallah, Rayan Abuzahra, Iyad Al-Jada

Institutions: Palestine Polytechnic University, Hebron University

Language: English

Topic: Case Reports on Hematomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090