Hayashi Kentaro, Hayashi Yukishige, Matsuo Yoshitaka, Shirakawa Kiyoshi, Kaminogo Makio
Department of Neurosurgery, Sasebo City General Hospital.
No Shinkei Geka. 2017 Jun;45(6):541-547. doi: 10.11477/mf.1436203546.
Metastatic brain tumor occasionally results in multiple cerebral hemorrhages. Here, we report a case of metastatic brain tumor complicated by multiple repeated cerebral hemorrhages. An 80-year-old man with a history of removal of lung cancer was admitted to our hospital because of disturbed consciousness following headache. A brain CT revealed a mass lesion of 40-mm diameter in the left cerebellum and a mass lesion of 2-mm diameter in the right temporal lobe. The cerebellar mass lesion showed homogeneous iso-density, indicating a subacute phase hemorrhage. Two days later, a follow-up CT revealed that the mass lesion had become high-density, indicating complication by a fresh hemorrhage. Hematoma was removed and histological examination was performed on the cerebellar lesion. There was leakage of dark-red liquid intraoperatively, and histological examination revealed an adenocarcinoma, indicating metastasis of the lung cancer. Additionally, necrosis and hemorrhage were identified. Postoperatively, whole brain irradiation was performed. The right temporal lesion gradually enlarged but disappeared after irradiation. In conclusion, multiple brain metastases may result in multiple cerebral hemorrhages. Repeated hemorrhage from necrosis of the carcinoma causes a slowly growing hematoma.
转移性脑肿瘤偶尔会导致多发性脑出血。在此,我们报告一例转移性脑肿瘤并发多发性反复脑出血的病例。一名80岁有肺癌切除史的男性因头痛后意识障碍入住我院。脑部CT显示左小脑有一个直径40毫米的肿块病变,右颞叶有一个直径2毫米的肿块病变。小脑肿块病变呈均匀等密度,提示亚急性期出血。两天后,随访CT显示肿块病变变为高密度,提示并发新鲜出血。清除血肿并对小脑病变进行组织学检查。术中见暗红色液体渗漏,组织学检查显示为腺癌,提示肺癌转移。此外,还发现了坏死和出血。术后进行了全脑照射。右颞叶病变逐渐增大,但照射后消失。总之,多发性脑转移可能导致多发性脑出血。癌坏死引起的反复出血导致血肿缓慢增大。