Background: Hemophilic pseudotumor is an uncommon complication in hemophiliacs. Most of the cases present a prior traumatic antecedent. About treatment, three possibilities are considered: conservative treatment, local radiotherapy, and radical surgery.Case Report: We describe a case of a 5-year-old male affected by hemophilia B who presented an hemophilic pseudotumor localized in the distal phalanx. The patient needed radical surgery after failure of conservative treatmemt.Conclusions: Our patient has a traumatic antecedent as an etiopathogenic factor, but the delay from trauma to admission to hospital seems to have contributed to the continous bleeding and the failure in conservative treatment. Age, injury’s location, radiotherapy side effects, and failure in substitutive therapy should be evaluated before considering surgery.

Keywords: pseudotumor, hemophilia, complications, Surgery