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Pathological fracture of a true tumour mimicking a haemophilic pseudotumor

In adult patients, filling the defect of a haemophilic pseudotumour with bone graft via the percutaneous insertion of a trocar into the cyst is a common treatment. Following aspiration of the contents, the cavity may be filled with cancellous bone graft, depending on the size of the cavity. The procedure has three main advantages: it is easy, straightforward and relatively non-invasive, it is cheap and it does not require lengthy hospitalization. On the other hand, pathological fracture of the affected bone in the site of a haemophilic pseudotumor is a rare but severe complication. We have had operated on a young haemophilic adult patient with an undisplaced pathological tibial fracture at the site of what we believed it was a haemophilic pseudotumor (Figs 1–4). The lesion was treated with the aforementioned percutaneous approach, i.e. to say curettage and filling with cancellous bone obtained from the Bone Bank at our institution (Figs 5 and 6). The pathological fracture was stabilised by means of an unreamed tibial nail (UTN) locked both proximally and distally (Figs 7 and 8). During the surgical procedure we took a specimen for histological analysis.