Treatment of late solidified hematoma in back donor site after breast reconstruction with latissimus dorsi flap: report of three cases

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Abstract

Background

Late solidified hematoma is a rare complication of breast reconstruction with latissimus dorsi (LD) flap. The majority of hematomas occur in the immediate postoperative period; however, some cases can occur at a distant point in time after surgery and do not have a definitive mechanism of injury or develop symptoms immediately after the triggering event. Moreover, treatment of hematoma has not yet been established.

Case presentation

Breast reconstruction with LD flap has been performed between January 2014 and June 2018 in more than 275 cases. We report 3 cases of late solidified hematoma at the back-donor site that have developed years after breast reconstruction with LD flap, in which a surgical approach was performed because the solidified hematomas could not be treated with percutaneous aspiration.

Conclusions

We report successful surgical treatment and histological findings of late-onset solidified hematoma as a rare complication of Breast reconstruction with LD flap.

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Most cited references 10

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Is Open Access

Elastofibroma dorsi: Clinical evaluation of 61 cases and review of the literature

Mehmet Ali Deveci, Hilmi Özbarlas, Kıvılcım Eren Erdoğan … (2016)

Objective Elastofibroma dorsi (ED) is a rare, benign, soft tissue tumor typically located between inferior corner of scapula and posterior chest wall causing mass, scapular snapping, and pain. When classic symptoms and localization are present, it is diagnosed without biopsy and treated with marginal resection. This study retrospectively analyzed patients operated on for ED to evaluate presenting symptoms, tumor size, complications, and clinical results, and to suggest optimal treatments. Methods This study included 51 patients who underwent surgery for ED in 2 different clinics between 2005 and 2015. Patient age, gender, profession, side affected, symptoms, average duration of symptoms, and tumor size were researched. Radiological examinations of patients were evaluated. Patients with lesions larger than 5 cm in size were operated on. Postoperative complications, recurrence, and functional results were evaluated using Constant score and compared to preoperative values. Results A total of 61 operated lesions of 51 patients clinically and radiologically diagnosed with ED were retrospectively evaluated. Average length of time patient experienced symptoms was 11.21 months. Lesions in 19 (37.2%) patients were bilateral, 10 of which were symptomatic and larger than 5 cm in size, meeting indication for surgery. Average lesion diameter was 8.7 cm. Average follow-up was 26.89 months. Average of preoperative Constant score of 67.28 subsequently increased to 92.88 (p < 0.05). Seroma and hematoma were observed in 11.5% of patients. Conclusion Generally, good clinical results can be obtained with marginal resection without requiring a biopsy, considering classic complaints and radiological appearance of ED. Level of evidence Level IV, Therapeutic study.

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Chronic expanding hematoma.

Randolph V. Lewis, Keven R. Johnson (1987)

Two cases of chronic expanding hematoma are presented. Although the location and presentation vary, chronic expanding hematoma has a distinct histopathologic pattern. A diagnosis of neoplasm is suggested by its slow growth pattern. The criteria for their formation are incompletely understood, and in one case, a hematoma occurred despite apparent adequate drainage. Computed tomography is helpful in distinguishing chronic expanding hematoma from other soft-tissue masses.

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Chronic expanding hematoma within a periprosthetic breast capsule.

J L Daw, V Lewis, J Smith (1996)

Three cases of chronic expanding hematoma occurring within the capsule surrounding breast implants are described. All developed at least 4 years after the last operation. No identifiable etiology could be demonstrated. Although this pathologic entity has been widely reported in other anatomic locations, a periprosthetic chronic expanding hematoma of the breast has not been described previously.

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Author and article information

Contributors

Joon Seok Lee: +82-53-420-5685 , leejspo@naver.com

Hyeon Jun Jeon: +82-53-420-5685 , fedor80@naver.com

Jeeyeon Lee: +82-53-420-5685 , j.lee@knu.ac.kr

Ho Yong Park: +82-53-420-5685 , phy123@knu.ac.kr

Jung Dug Yang:

ORCID: http://orcid.org/0000-0002-9121-3604

+82-53-420-5685 , lambyang@knu.ac.kr

Journal

Journal ID (nlm-ta): BMC Surg

Journal ID (iso-abbrev): BMC Surg

Title: BMC Surgery

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2482

Publication date (Electronic): 20 May 2019

Publication date PMC-release: 20 May 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 51

Affiliations

[1 ]ISNI 0000 0001 0661 1556, GRID grid.258803.4, Department of Plastic and Reconstructive Surgery, School of Medicine, , Kyungpook National University, ; 130 Dongdeok-ro, Jung-gu, Daegu, 700-421 South Korea

[2 ]ISNI 0000 0001 0661 1556, GRID grid.258803.4, Department of Surgery, School of Medicine, , Kyungpook National University, ; Hoguk-ro 807, Buk-gu, Daegu, 41404 South Korea

Author information

Jung Dug Yang http://orcid.org/0000-0002-9121-3604

Article

Publisher ID: 516

DOI: 10.1186/s12893-019-0516-6

PMC ID: 6528295

PubMed ID: 31109327

SO-VID: b89d4878-414a-4d4f-92fc-de917dd54f69

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 3 October 2018

Date accepted : 14 May 2019

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ScienceOpen disciplines: Surgery

Keywords: breast reconstruction,latissimus dorsi flap,chronic expanding hematoma,solidified hematoma,late hematoma

Data availability:

ScienceOpen disciplines: Surgery

Keywords: breast reconstruction, latissimus dorsi flap, chronic expanding hematoma, solidified hematoma, late hematoma

Treatment of late solidified hematoma in back donor site after breast reconstruction with latissimus dorsi flap: report of three cases

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Abstract

Background

Case presentation

Conclusions

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25th European Students' Conference

Most cited references 10

Elastofibroma dorsi: Clinical evaluation of 61 cases and review of the literature

Chronic expanding hematoma.

Chronic expanding hematoma within a periprosthetic breast capsule.

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