Jang Se Youn, Kim Choong Hyun, Cheong Jin Hwan, Kim Jae Min
Department of Neurosurgery, Seoul Medical Center, Seoul, Korea.
Department of Neurosurgery, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Brain Tumor Res Treat. 2015 Apr;3(1):48-51. doi: 10.14791/btrt.2015.3.1.48. Epub 2015 Apr 29.
Hemorrhagic metastatic brain tumors of hepatocellular carcinoma (HCC) are rare and have been mostly presented as intracranial hemorrhage (ICH). A 51-year-old male patient presented with sudden altered level of consciousness. He suffered from HCC since 2010 and transarterial chemoembolization was performed three times for HCC. The brain computed tomography (CT) scans revealed subdural hematoma (SDH) in the right fronto-temporal area and 6.0×3.5 cm sized ICH in the right parieto-occipital lobe. Brain angiographic CT scans demonstrated that the hemorrhagic lesions did not include any enhancing lesions and vascular abnormalities. We undertook a decompressive craniectomy and evacuation of the acute SDH and ICH. During evacuation of ICH, the yellowish mass was observed in the cortical surface of the right occipital lobe. Pathological examination displayed the findings of metastatic brain tumor from HCC. Metastatic brain tumors should be considered in the differential diagnosis as a cause of spontaneous SDH with ICH.
肝细胞癌（HCC）的出血性转移性脑肿瘤较为罕见，大多表现为颅内出血（ICH）。一名51岁男性患者出现意识水平突然改变。他自2010年起患有HCC，曾因HCC接受过三次经动脉化疗栓塞术。脑部计算机断层扫描（CT）显示右额颞区硬膜下血肿（SDH）以及右顶枕叶有一个6.0×3.5厘米大小的ICH。脑部血管造影CT扫描显示出血性病变不包括任何强化病变和血管异常。我们进行了减压颅骨切除术并清除急性SDH和ICH。在清除ICH过程中，在右枕叶皮质表面观察到淡黄色肿块。病理检查显示为HCC转移性脑肿瘤的表现。在鉴别诊断自发性SDH合并ICH的病因时应考虑转移性脑肿瘤。
