Kim Joo-Hwan, Gwak Ho-Shin, Hong Eun Kyung, Bang Chang Whan, Lee Sang Hyun, Yoo Heon
Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea.
Department of Pathology, National Cancer Center, Goyang, Korea.
Brain Tumor Res Treat. 2015 Apr;3(1):30-3. doi: 10.14791/btrt.2015.3.1.30. Epub 2015 Apr 29.
Meningiomas are the most common benign intracranial tumors and make up 13-26% of all primary intracranial tumors. Clinical presentation of hemorrhage is rare in these tumors occurring in approximately 1.3% of cases and subdural hemorrhages are even more uncommon. The mechanism of hemorrhage is still unclear and may vary according to histologic type, location and the type of hemorrhage. We experienced a case of 61-year-old woman with a benign meningioma presenting as a subdural hemorrhage. She developed sudden onset of headache right after aggressively coughing. Her headache persisted for a week before she was admitted to the emergency room of National Cancer Center. She had a past medical history of ovarian cancer which had been treated and was allegedly recurrence-free for 2 years. At the time of admission, a headache was the only symptom and imaging studies showed a right frontal hemorrhagic subdural mass lesion accompanying an ipsilateral subdural hematoma. Elective surgery was performed and intraoperative findings revealed the hallmark characteristics of a meningioma with mixed stage diffuse subdural hematoma. Permanent pathology result determined it was a conventional meningioma (World Health Organization grade I). From this case, we discuss the rare presentation of subdural hemorrhage in meningioma and related points by reviewing the literature of previous studies.
脑膜瘤是最常见的颅内良性肿瘤,占所有原发性颅内肿瘤的13 - 26%。这些肿瘤出现出血的临床表现很罕见,约1.3%的病例会发生,而硬膜下出血则更为少见。出血机制仍不清楚,可能因组织学类型、位置和出血类型而异。我们遇到一例61岁女性,患有良性脑膜瘤,表现为硬膜下出血。她在剧烈咳嗽后突然出现头痛。头痛持续了一周后才被送往国家癌症中心急诊室。她既往有卵巢癌病史,已接受治疗,据称已无复发2年。入院时,唯一症状是头痛,影像学检查显示右侧额叶出血性硬膜下肿块病变伴同侧硬膜下血肿。进行了择期手术,术中发现显示为脑膜瘤的典型特征以及混合期弥漫性硬膜下血肿。永久病理结果确定为传统型脑膜瘤(世界卫生组织I级)。通过回顾以往研究的文献,我们从这个病例讨论了脑膜瘤中硬膜下出血的罕见表现及相关要点。