Background: Soft tissue sarcoma can mimic intramuscular hematoma in rare cases. We report one patient with rhabdomyosarcoma mimicking traumatic intramuscular hematoma.
Case report: A 60-year-old patient had an episode of minor trauma to the lower limb. Initial clinical and image findings interpreted the swollen lump as an intramuscular hematoma. A few months later, the lesion had grown (16x4cm) and the pain worsened. After serial MRI exams, needle biopsy, and surgical resection, the final result showed pleomorphic rhabdomyosarcoma.
Discussion: Soft tissue sarcoma mimicking traumatic intramuscular hematomas in the extremity has rarely been reported in the literature. Chronic expanding hematoma over soft tissue can manifest as a space-occupying lesion which mimics a sarcoma. Accurately diagnosing this condition is challenging for the clinician. It is important to evaluate prior trauma history, perform serial images and even a biopsy with an unusual presentation of traumatic hematoma in the extremities. MRI is an important diagnostic tool, but if there is any doubt, a serial MRI and biopsy can help avoid the tragic consequences of a missed soft tissue sarcoma.
Conclusion: It may be difficult to differentiate soft tissue sarcoma from traumatic intramuscular hematoma due to similarities in clinical presentation and image characteristic. Careful history taking, serial MRI, and biopsy can assist in a more accurate diagnosis.