Background/Objectives: Spontaneous chest wall hematomas are rare but potentially life-threatening complications, particularly in patients with multiple comorbidities such as those undergoing hemodialysis. This case report aims to highlight the significance of early diagnosis and appropriate management in preventing complications associated with this condition. Methods: We report the case of a 79-year-old man with end-stage renal disease on hemodialysis, presenting with a large spontaneous hematoma (18.7 × 13.1 × 9.6 cm) in the right upper chest wall. Initial interventions, including diagnostic imaging and transarterial angiography, did not detect active bleeding. Surgical exploration revealed bleeding from a branch of the lateral thoracic artery, which was managed through vessel ligation and hematoma drainage. Results: The hematoma was successfully managed through surgical intervention, with no postoperative complications such as infection, recurrent bleeding, or wound issues. The patient’s recovery was uneventful, and he was discharged in stable condition. This case underscores the role of microvascular fragility and uremic coagulopathy in the development of spontaneous bleeding in hemodialysis patients. Conclusions: This case emphasizes the importance of timely recognition and individualized management of spontaneous soft tissue bleeding in hemodialysis patients. Surgical intervention is necessary for large hematomas or cases of hemodynamic instability to ensure hemostasis and mitigate complications.

Pediatric patients who undergo implant insertion into the chest wall face a high risk of implant exposure to the external environment. Five months after an 8-year-old boy underwent implantable cardioverter–defibrillator (ICD) implantation in a subcutaneous pocket in the left anterolateral chest wall to manage long QT syndrome, ICD replacement became necessary owing to exposure risk from distal and lateral thinning of the ICD pocket. Pocket rupture and exposure would increase the risk of infection; therefore, we performed ICD removal and primary pocket closure. Two weeks later, a new suprafascial pocket was created, an acellular dermal matrix (ADM) was attached to the inner wall to prevent ICD protrusion, and a new ICD was inserted. One year postoperatively, the ADM was engrafted, and no complications were observed. A thin subcutaneous layer increases the risk of ICD implantation complications. Inner wall strengthening with an ADM can help prevent pocket rupture.

Background: Infraorbital nerve dysfunction frequently occurs after maxillary fractures. This study aimed to determine whether maxillary fractures involving the infraorbital foramen affect the recovery of infraorbital nerve function.Methods: In this prospective study, 60 patients who received treatment for unilateral maxillary fractures between January 2020 and December 2022 were analyzed, with a follow-up period of over 1 year. Computed tomography scans were employed to categorize the fractures into three types according to the location of the fracture line relative to the infraorbital foramen. Sensory changes in four predetermined areas, supplied by the infraorbital nerve, were evaluated preoperatively and at 1 week, 1 month, 3 months, 6 months and 1 year postoperatively using the two-point discrimination test and the monofilament test.Results: Paresthesia was observed in all patients with maxillary fractures. In the majority of instances, sensory deficits resolved spontaneously within 1 year. However, in patients whose fracture lines encroached upon the infraorbital foramen, the severity of paralysis was greater, and the rates of recovery were slower.Conclusion: The degree of infraorbital nerve function after a maxillary fracture was influenced by the involvement of the infraorbital foramen. Therefore, in the management of patients with maxillary fractures, computed tomography scans can serve as a predictive tool for the potential severity of paresthesia and the anticipated recovery rate.

Background/Objectives: Forehead lipomas are benign but cosmetically conspicuous. Direct transcutaneous incision allows easy removal but often leaves visible scars. Hairline approaches conceal scars but are unsuitable for bald or high-hairline patients and lower forehead lipomas. We evaluated a peri-eyebrow approach using a superior brow-margin incision versus conventional methods. Methods: We retrospectively reviewed 176 patients who underwent forehead mass excision between 2008 and 2025. After exclusions, 97 biopsy-proven lipomas were analyzed (peri-eyebrow 22; hairline 38; direct 37). Variables included lipoma location, vertical ratio (lipoma position between the hairline and eyebrow), lipoma size, and incision length. Logistic regression assessed the relationship between vertical ratio and peri-eyebrow incision selection. Multivariate logistic regression identified independent predictors, and bootstrap validation (1000 iterations) assessed the internal stability of the ROC cut-off. Scar quality was evaluated using the Patient and Observer Scar Assessment Scales. Results: Peri-eyebrow incisions were used only for midline or median lipomas. The vertical ratio was highest in the peri-eyebrow group (0.70 ± 0.10) and independently predicted incision choice (adjusted OR per 0.1-unit increase 3.32, p < 0.001). ROC analysis showed excellent discrimination (AUC 0.872), and the bootstrapped AUC (0.802, 95% CI 0.727–0.878) confirmed robust internal validity. The optimal 0.615 cut-off yielded 0.82 sensitivity and 0.79 specificity. Peri-eyebrow and hairline incisions achieved significantly better scar scores than direct incisions (p < 0.001). Conclusions: The peri-eyebrow incision is a safe and cosmetically effective alternative when hairline incisions are unsuitable. It offers concealed scars and outcomes comparable to hairline incisions.

Thin people who undergo implant insertion into the chest wall face a high risk of implant exposure to the external environment. Five months after an 8-year-old boy underwent implantable cardioverter-defibrillator (ICD) implantation in a subcutaneous pocket in the left anterolateral chest wall to manage long QT syndrome, ICD replacement became necessary owing to exposure risk from distal and lateral thinning of the ICD pocket. Pocket rupture and exposure would increase the risk of infection; therefore, we performed ICD removal and primary pocket closure. Two weeks later, a new suprafascial pocket was created, acellular dermal matrix (ADM) was attached to the inner wall to prevent ICD protrusion, and a new ICD was inserted. One year postoperatively, the ADM was engrafted, and no complications were observed. A thin subcutaneous layer increases the risk of ICD implantation complications. Inner wall strengthening with ADM can help prevent pocket rupture.

Synovial sarcoma is a high-grade malignant soft tissue tumor associated with poor survival that mainly occurs in young adults and adolescents. We report a rare case of forearm synovial sarcoma with local venous invasion in an 87-year-old woman. She presented with a painful enlarging mass in the left forearm. Contrast-enhanced magnetic resonance imaging revealed a 20×10×7 cm lobulated mass involving both the anterior and posterior compartments. Positron emission tomography-computed tomography showed no distant metastasis or regional lymph node involvement. Histological examination confirmed grade 2 monophasic synovial sarcoma. Abnormal enlargement of the cephalic, median cubital, basilic, and brachial veins was observed 5 cm proximal to the tumor. Transhumeral amputation was performed with a 2-cm surgical margin from the proximal end of the enlarged vessels. No tumor cells were identified at the amputation margin. At 12 months after surgery, the patient showed no recurrence or metastasis.