Subdural hematoma associated with metastatic neoplasms

McKenzie, Clark R.; Rengachary, Setti S.; McGregor, Douglas H.; Dixon, Anita; Suskind, Dana L.

doi:10.1097/00006123-199010000-00019

Cited by 18 publications

(18 citation statements)

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“…Cancer is an uncommon cause of SDH, with less than 100 cases reported in the literature [2][3][4][5][6][7][8]. Imbalances between blood coagulation and fibrinolysis and/or thrombocytopenia resulting from advanced cancer are presumed pathomechanisms of SDH in such patients [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Imbalances between blood coagulation and fibrinolysis and/or thrombocytopenia resulting from advanced cancer are presumed pathomechanisms of SDH in such patients [1][2][3][4][5]. The most frequent cancer types associated with SDH include gastric, prostate, lung, and leukemia [2][3][4][5][6][7][8], all of which are relatively common among geriatric population. By contrast, SDH associated with angiosarcoma is extremely rare: despite vigorous literature search, we could identify only two previous cases [11,12]: in one case, an angiosarcoma originated from the skull [11], and in the other case, the tumor originated from the scalp [12].…”

Section: Discussionmentioning

confidence: 99%

“…There seems to be a difference between SDH caused by angiosarcomas and that caused by other common cancers in the clinical presentation. In the latter, the diagnosis of cancer has almost always been established by the time SDH develops [2][3][4][5][6][7]. By contrast, the diagnosis of angiosarcoma has been made only after surgery for SDH, and diagnostic delay is the rule rather than exception [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Although cancers metastatic to the skull or dura may cause SDH in rare instances, the presence of underlying cancers has almost always been known for months to years [2][3][4][5][6][7][8]. We experienced a case of skull angiosarcoma manifesting as SDH, posing a diagnostic challenge to physicians because of its rarity and unusual presentation.…”

Section: Introductionmentioning

confidence: 99%

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Subdural Hematoma Caused by Epithelioid Angiosarcoma Originating from the Skull

Yamada

Inamasu

Moriya

et al. 2012

Head and Neck Pathol

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Cancers metastatic to the skull or dura may cause subdural hematoma (SDH). However, the frequency is low, and the presence of underlying cancers has almost always been known in such situations. We report a case of skull angiosarcoma manifesting as SDH, posing a diagnostic challenge to physicians. A 75-year-old man visited our clinic with sensorimotor disturbance of gradual onset approximately 1 month after a minor head trauma. He was diagnosed with SDH after imaging studies, and underwent surgery to evacuate the hematoma. Because the hematoma was organized, surgery was switched from burr-hole drainage to craniotomy. The bone flap as well as the dura over the hematoma had grossly normal appearance, and only the hematoma itself was submitted for histological examination. Although postoperative recovery was uneventful, the patient experienced recurrence of the SDH 2 months after surgery. At the second surgery, the bone flap and dura were intermingled with tumor tissue, and histological examination revealed that an epithelioid angiosarcoma originating from the skull was responsible for the SDH. Timely diagnosis of angiosarcoma manifesting as SDH is difficult because of its rarity. In retrospect, however, the diagnosis might have been established earlier if the bone flap and/or the dura had been biopsied at the time of the first surgery. The present case gives us a lesson that SDH may be an unusual manifestation of malignant tumors of skull or dural origin, and histological examination of not only hematoma capsule but also of the surrounding tissues may provide important diagnostic clues.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subdural Hematoma Caused by Epithelioid Angiosarcoma Originating from the Skull

Yamada

Inamasu

Moriya

et al. 2012

Head and Neck Pathol

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Metastases from Thoracic Tumors

TxNxM1

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Acute aggravation of subdural fluid collection associated with dural metastasis of malignant neoplasms: case report and review of the literature

et al. 2013

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A 63-year-old woman was admitted to our hospital with serious headache and vomiting. Five months before admission, she had undergone surgery for a primary advanced gastric cancer. Neuroradiological examinations revealed subdural fluid collection. We twice performed evacuation of the subdural fluid collection. However, aggravation of her state of consciousness progressed and she passed away. Histological examinations demonstrated that the dural veins were infiltrated by numerous tumor cells that produced mucus; however, ruptured vessels were not found. Furthermore, the subdural fluid collection increased shortly after the initial operation. We infer that the cause of the collection, which was associated with the dural metastasis of malignant tumors, was not only mucin secretion by tumor cells but also a rapid increase in perfusion pressure in the vessels of the dura mater, resulting in extravasation of plasma components into the subdural space. Our case demonstrates that the pathogenetic mechanism that is specific for subdural fluid collection caused by dural metastasis of malignant tumors differs from the mechanism of production of subdural hematoma associated with dural metastasis.

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Subdural hematoma associated with metastatic neoplasms

Abstract: Two cases of subdural hematoma, one acute and the other chronic, associated with cancer metastatic to the dura are reported. Various mechanisms of the association of hematomas with cancer are reviewed.

Cited by 18 publications

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Subdural Hematoma Caused by Epithelioid Angiosarcoma Originating from the Skull

Subdural Hematoma Caused by Epithelioid Angiosarcoma Originating from the Skull

Metastases from Thoracic Tumors

Acute aggravation of subdural fluid collection associated with dural metastasis of malignant neoplasms: case report and review of the literature

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