Total femoral replacement for treatment of a massive femoral hemophilic pseudotumor: a case report and review of the literature

Hemophilic pseudotumor (HP) is a rare complication of hemophilia, which occurs in a wide spectrum of bones and soft tissues. A case of a massive femoral HP in a Chinese adult is reported. With adequate infusion clotting factor VIII replacement therapy in the perioperative period, the patient had a radical resection of HP and reconstruction with a custom total femoral prosthesis. The patient was followed up for 4 years, he resumed walking with crutches and there was no evidence of recurrence. Various treatment strategies have been used to treat HP, however, there is no agreement about the first-line therapy. The choice of therapy depends on many parameters, such as the size and location of the pseudotumor, the age of the patient, and the relation with underlying organs. We reviewed the current treatment options reported in the literature as well in order to provide valuable suggestions in management of this rare but complicated pathological trouble.