# A Case of Chronic Expanding Hematoma Following Extraperiosteal Paraffin Plombage After 50 Years

## TL;DR

A man developed a rare chronic expanding hematoma 50 years after a historical paraffin plombage procedure for tuberculosis, requiring surgical removal.

## Contribution

Reports a rare long-term complication of extraperiosteal paraffin plombage and advocates for surgical intervention in symptomatic cases.

## Key findings

- Chronic expanding hematoma occurred 50 years after paraffin plombage for pulmonary tuberculosis.
- Surgical excision confirmed the diagnosis and resolved the issue.
- Late complications from paraffin plombage can be both benign and malignant.

## Abstract

Chronic expanding hematoma (CEH) is a late complication of extraperiosteal paraffin plombage. Various late complications have been reported with this historical procedure, including expanding hematoma, paraffinoma, blood specimens complicating chronic empyema, and malignant tumors. A 75-year-old male presented with left-sided lateral chest pain. Fifty years prior, he had undergone a left upper lobectomy with extraperiosteal paraffin plombage for pulmonary tuberculosis. Three years before the current presentation, he had been admitted to another hospital with fever. At that time, a chest computed tomography (CT) scan showed the expanding plombage and a mass in the plombage. Upon referral to our institute, contrast-enhanced CT showed strong enhancement of part of the mass, and a CEH was suspected. The paraffin and hematoma were surgically removed. Pathological diagnosis was a CEH. Plombaged paraffin can lead to both malignant and benign complications even decades after the initial procedure. Surgical excision should be considered in symptomatic cases or when there is an expanding mass in the plombage space.