A Case of a Giant Hematoma due to Neurofibromatosis

Abstract

A case of giant hematoma due to neurofibromatosis in a 73-year-old woman is reported. At 70 years of age, after ablation for paroxysmal atrial fibrillation, anticoagulant therapy was continued. When going to the toilet, she noticed a table- tennis ball-sized tumor in her left hip, and because of the rapid enlargement of the hip tumor, she was brought to the emergency department. In the left hip there was a very large, 16 × 14 cm, subcutaneous hematoma, accompanied by spontaneous pain, and across her entire body, chestnut/azuki bean-sized neurofibromas and pigmented patches (café au lait spots) were observed. From the physical findings, Neurofibromatosis type 1 was diagnosed. Because anemia developed, anticoagulant therapy was stopped. Then, after blood transfusion and hematoma compression, elective surgery involving hematoma and tumor resection was performed on the 5th day of hospitalization. It is believed that the causes of bleeding in this case were the anticoagulant therapy and the ease at which neurofibromas bleed.