Rationale: Morel-Lavallée lesions (MLLs) represent closed degloving injuries resulting from traumatic separation of skin/subcutaneous tissue from deep fascia. While typically associated with high-energy trauma, diagnosis becomes challenging in cases with occult trauma, complex comorbidities, or tumor-mimicking imaging features. This case report aims to highlight the diagnostic challenges and management strategy of MLL in a patient with a history of malignancy and anticoagulant therapy, underscoring the importance of pathological confirmation in atypical presentations. Patient concerns: A 56-year-old woman was diagnosed with: MLL, hypertension, type II diabetes mellitus, status post meningioma resection, status post hysterectomy for cervical cancer, and status post inferior vena cava filter placement. Hip magnetic resonance imaging revealed soft tissue infiltration. Following comprehensive history review and pathological evaluation, malignancy was excluded, confirming the diagnosis of MLL. Diagnoses: Morel-Lavallée lesion. Interventions: Initial management included intravenous antibiotic therapy (cefazolin, 1 g twice daily) and percutaneous aspiration of fluid for pathological examination. Following exclusion of malignancy, the patient underwent debridement of peritrochanteric soft tissues with subsequent application of vacuum sealing drainage. Outcomes: The patient showed significant clinical improvement following percutaneous aspiration and antibiotic therapy. After surgical debridement and vacuum sealing drainage application, the wound healed completely without recurrence. She was discharged after an additional week of postoperative antibiotics and supportive care, with no complications at 1-month follow-up. Lessons: MLL require differential diagnosis from soft tissue neoplasms, particularly in patients with a history of malignancy. Anticoagulation may predispose to occult MLL development. Consequently, pathological examination is essential to establish a definitive diagnosis of MLL.
Li et al. (Fri,) studied this question.