Rivaroxaban-induced breast spontaneous hematoma: a case report

Rivaroxaban is a highly selective Xa factor inhibitor, and oral administration of rivaroxaban has a diminished risk of major bleeding when compared to the risk of bleeding in patients receiving the standard anticoagulation treatment. Here, we report the case of a 71-year-old female who developed a spontaneous hematoma after receiving rivaroxaban, the patient taken rivaroxaban due to veins cava filter implantation in a lower extremity, at a dosage of 10 mg per day. During the hospital stay, the patient had a blood test and cytologic examination, no obvious coagulopathy and malignant cells found, ultrasonography showed a hypoechoic mass measuring 3.8 x 4.7 cm with areas of cystic degeneration. The patient accepted the puncture drainage treatment for the hematoma. Physical condition of her is good for 1 year since the onset of the disease. The risk of hemorrhage when taking new oral anticoagulants like rivaroxaban is lower than when taking traditional anticoagulants, but clinicians should be aware of the potential for serious complications such as local hematoma. We supply some measures to analyze and treat novel oral anticoagulant induced bleeding that may be helpful for clinicians.