{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T11:27:24Z","timestamp":1768217244302,"version":"3.49.0"},"reference-count":8,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>\n                    Hemophilic pseudotumor is a rare complication of hemophilia in which a chronic, expanding hemorrhagic mass erodes adjacent bone; intracranial presentations are exceedingly uncommon and can mimic neoplasms. We describe a 36-year-old man with severe hemophilia A who developed a five-year, progressively enlarging left frontoparietal swelling with worsening right-sided hemiparesis. MRI demonstrated a heterogeneously enhancing extra-axial lesion destroying the left cranial vault with \u201cmushroom-like\u201d extracranial extension, marked mass effect, and midline shift, initially interpreted as a possible meningioma. Given progressive deficits, the patient underwent resection under intensive factor VIII replacement. Intraoperatively, a 10\u2009\u00d7\u200910\u2009\u00d7\u20095\u2005cm encapsulated lesion containing organizing clot and fibrous tissue was excised\n                    <jats:italic>en bloc<\/jats:italic>\n                    ; the skull defect was reconstructed in a staged procedure. Histopathology confirmed hemophilic pseudotumor. Postoperatively, hemiparesis improved markedly; a small epidural hematoma was managed conservatively. At 12 months, MRI showed no recurrence and the patient remained neurologically intact on prophylactic factor VIII. This case highlights the need to include hemophilic pseudotumor in the differential diagnosis of skull lesions in patients with hemophilia and underscores the value of early recognition and multidisciplinary management\u2014particularly meticulous perioperative hemostatic support\u2014to enable safe resection and excellent outcomes.\n                  <\/jats:p>","DOI":"10.3389\/fsurg.2025.1709321","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:13:25Z","timestamp":1768205605000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Intracranial hemophilic pseudotumor mimicking an aggressive neoplasm: a rare skull-invasive presentation"],"prefix":"10.3389","volume":"12","author":[{"given":"Moksada","family":"Regmi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junyi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenlong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1016\/j.surneu.2007.01.071","article-title":"Cranial hemophilic pseudotumor associated with factor IX deficiency: case report","volume":"69","author":"Inoue","year":"2008","journal-title":"Surg Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1097\/00006123-199612000-00035","article-title":"Cranial hemophilic pseudotumor: case report","volume":"39","author":"Sim","year":"1996","journal-title":"Neurosurgery"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e369","DOI":"10.1097\/SCS.0000000000000856","article-title":"Bilateral cranial hemophilic pseudotumor","volume":"25","author":"Xu","year":"2014","journal-title":"J Craniofac Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/hae.14046","article-title":"WFH guidelines for the management of hemophilia, 3rd edition","volume":"26","author":"Srivastava","year":"2020","journal-title":"Haemophilia"},{"key":"B5","first-page":"121","article-title":"Hemophilic pseudotumors: diagnosis and management","volume":"8","author":"Rodriguez-Merchan","year":"2020","journal-title":"Arch Bone Jt Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1111\/j.1365-2516.2008.01942.x","article-title":"Management of haemophilic pseudotumours with special emphasis on radiotherapy and arterial embolization","volume":"15","author":"Espandar","year":"2009","journal-title":"Haemophilia"},{"key":"B7","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1186\/s13018-021-02426-1","article-title":"Surgical treatment for patients with hemophilic pseudotumor-related femoral fracture: a retrospective study","volume":"16","author":"Chen","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"B8","first-page":"514","article-title":"Various surgical treatment of hemophilic pseudotumor: a case series","volume":"7","author":"Kamal","year":"2019","journal-title":"Arch Bone Jt Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1709321\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:13:26Z","timestamp":1768205606000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1709321\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":8,"alternative-id":["10.3389\/fsurg.2025.1709321"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1709321","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"article-number":"1709321"}}