DOI: 10.36347/sjmcr.2016.v04i09.009

Pages: 657-659

A 66-year-old female noticed right thoracic back pain when she woke up in the morning in 5 days. This gradually deteriorated and called an ambulance. She did not have any episode of trauma. She had a history of essential thrombocythemia, cerebral infraction and was prescribed aspirin, clopidrogel, ethyl icosapentate and hydroxyurea. Upon arrival, she was in a state of shock. The physiological finding was a subcutaneous mass at the right thoracic back. After the rapid infusion, she smoothly obtained stable circulation. Truncal enhanced computed tomography depicted a right chest wall mass with extravasation of contrast medium without evidence of tumor or vascular malformation. The platelet count was 304 × 104/mm3. She was treated by embolization. After confirmation of shrinkage of the hematoma on CT and a decrease to under 100 × 104/mm3 in the platelet level with a prescription of hydroxyurea, she restarted her aspirin prescription and was discharged on foot on foot on the 12th hospital day. This is the first case of spontaneous chest wall hematoma induced by essential thrombocythemia and/or the second case induced by side effects of antiplatelet drugs. Given that hematological disease can cause hematoma in the soft tissue, physicians should consider the formation of a life-threatening hematoma when a patient who might have hemorrhaging induced by drugs or hematological disease complains of pain in the soft tissue.