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Radiological features of intrathoracic chronic expanding hematoma: A case report 80988585 猪俣, 麻佑 イノマタ, マユ Inomata, Mayu 猪俣 イノマタ Inomata 麻佑 マユ Mayu 宮崎大学 University of Miyazaki 黒木, 将英 クロキ, ショウエイ Kuroki, Shoei 黒木 クロキ Kuroki 将英 ショウエイ Shoei 00363599 中田, 博 ナカダ, ヒロシ Nakada, Hiroshi 中田 ナカダ Nakada 博 ヒロシ Hiroshi 宮崎大学 University of Miyazaki 河野, 文耶 カワノ, フミヤ Kawano, Fumiya 河野 カワノ Kawano 文耶 フミヤ Fumiya 宮崎大学 University of Miyazaki 00648769 前田, 亮 マエダ, リヨウ Maeda, Ryo 前田 マエダ Maeda 亮 リヨウ Ryo 宮崎大学 University of Miyazaki open access © 2023 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. Case report Chronic expanding hematoma Intrathoracic Surgery Introduction and importance We present a relatively rare case of intrathoracic chronic expanding hematoma (CEH) after thoracic surgery for lung cancer. CEH is often difficult to distinguish from malignant tumors because of its large size and slow progressive enlargement. In this report, we describe the radiological features of CEH in detail. Case presentation A 67-year-old man who underwent a left upper lobectomy for lung cancer at 46 years of age presented with hemosputum. Computed tomography revealed a large mass with central low attenuation. Calcification was detected in peripheral lesions of the mass. T2-weighted magnetic resonance imaging (MRI) revealed a mass with mixed low and high signal intensities. Based on the clinical course, the patient was diagnosed with an intrathoracic CEH. A left posterolateral thoracotomy was performed with the patient in the lateral position, and a mass encased in a tough capsule was resected. The postoperative histopathological findings were consistent with CEH. Clinical discussion CT of intrathoracic CEH shows a lesion with heterogeneous content, a thick wall, and calcifications. However, differentiation from malignant tumors is difficult using CT alone. MRI is a good diagnostic modality for CEH and often shows a mixture of low- and high-intensity areas on T2-weighted images. In addition, the patient's medical history is important because most cases of CEH have a history of trauma or surgery. Conclusion To diagnose intrathoracic CEH, it is essential to consider the patient's clinical course and MRI findings. Citation: Inomata M, Kuroki S, Nakada H, Kawano F, Maeda R. Radiological features of intrathoracic chronic expanding hematoma: A case report. Int J Surg Case Rep. 2023 Sep;110:108767. doi: 10.1016/j.ijscr.2023.108767. Epub 2023 Aug 29. PMID: 37683511; PMCID: PMC10510069. Elsevier 2023-09 eng journal article VoR http://hdl.handle.net/10458/0002000357 https://miyazaki-u.repo.nii.ac.jp/records/2000357 https://doi.org/10.1016/j.ijscr.2023.108767 22102612 International Journal of Surgery Case Reports 110 108767 https://miyazaki-u.repo.nii.ac.jp/record/2000357/files/1-s2.0-S2210261223008969-main.pdf application/pdf 9.1 MB 2023-12-08