Subdural Metastatic Adenocarcinoma Mimicking Chronic Subdural Hematoma in Image Features and Clinical Presentation

Abstract

We report a case of subdural metastasis in which the clinical features and associated images mimic chronic subdural hematoma. Despite a known history of systemic metastasis of adenocarcinoma, the initial diagnosis and treatment were directed toward chronic subdural hematoma. During burr-hole operation, the subdural space was found to be filled will solid tumor rather than chronic hematoma. Pathology examination confirmed metastatic adenocarcinoma. The patient received subsequent whole brain irradiation and died 3 months after operation. Similar situations have rarely been reported in the literature. CT and MRI with enhancement can be adequate tools for differential diagnosis. On the other hand, chronic subdural hematoma may be a presentation of dural metastasis or a target of metastasis. We conclude that if a patient has history of cancer, subdural metastasis should be considered and brain CT or MRI be performed with contrast enhancement when making differential diagnosis of subdural collection. Furthermore, dural and outer membrane specimens should be taken during operation for chronic subdural hematoma in patients with malignancy.