Dural metastasis in patients with malignant neoplasm and chronic subdural hematoma

Objectives - Dural metastasis associated with chronic subdural hematoma (CSH) is rare in patients with malignant neoplasm. In this study, biopsy of the dura and cytological examination of the subdural hematoma was performed for patients with malignant neoplasm and chronic subdural hematoma to investigate the association of dural metastasis and CSH. Materials and methods - Four patients with malignant neoplasm (one breast, one lung, and one colon cancers, and one lymphoma) were diagnosed with CSH. Biopsy of the dura and cytological examination of the subdural fluid were performed for each of these patients. Results - Pathological examination of the dura revealed metastasis for two patients (one lymphoma and one breast cancer), with no specific change except neomembrane formation revealed for the dura of the other two patients. The cytology study was negative for all four patients. All these four patients died within 10 days of the operation; one from recurrent subdural hematoma, and three from infection. Conclusion - The results suggest that dural metastasis should be considered in patients with malignant neoplasm and CSH. Further, the prognosis for patients with malignant neoplasm and CSH may be poor because of systemic metastasis and the side-effects of chemotherapy.