AIMS: Haemophilic pseudotumor (HPT) is a rare but challenging complication of 
haemophilia. This study was intended to provide our experience about clinical 
characteristics and surgical treatment of HPT.
METHODS: Clinical medical records were retrieved from the Hemophilia Center, 
Nanfang Hospital, to identify the patients who had been surgically treated from 
1 January 2006 to 31 December 2017 with a definite diagnosis of HPT. Their 
clinical features, surgical management, outcomes and complications after surgery 
were analysed.
RESULTS: We identified 34 patients with HPT who had surgical treatment over a 
12-year period and five of them had multiple HPTs. The incidence of HPT at this 
centre was 2.3% over the dozen years. A previous trauma leading to the 
development of HPT was reported in 18 cases (52.9%). The HPT affected only soft 
tissue in 7 patients, bone and soft tissue in 25 ones and joint in 2 ones. 
Preoperative infection and fistula formation happened in ten patients, two of 
whom were related to abdominal HPTs. Enterococcus faecalis was cultured in five 
cases with fistula formation. HPT associated with pathological fracture was 
observed in five cases, two of whom were treated by external fixation and 3 by 
HPT resection and metallic internal fixation. Amputation was performed for nine 
patients, 6 of whom had preoperative infection and fistula formation. Their 
follow-up duration averaged 4.2 ± 2.9 years (range, from 1 to 13.5 years) after 
surgery. Of all our cases, three suffered from postoperative infection, five 
from recurrence of HPT and two with external fixation from fracture non-union.
CONCLUSIONS: HPT patients with preoperative infection had worse prognosis than 
those without. Surgical treatment plus intensive replacement therapy was 
effective for HPT but with a high rate of complications. HPT resection and 
metallic internal fixation rather than external fixation should be recommended 
for HPT patients with pathological fracture.