Spontaneous acute epidural hematoma secondary to skull and dural metastasis of hepatocellular carcinoma: A case report  

作　　者：Guang-Zhao Lv Guo-Chao Li Wei-Tai Tang Dong Zhou Yong Yang 

机构地区：[1]Department of Neurosurgery,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,Guangdong Province,China [2]Department of Neurosurgery,Luoding People’s Hospital,Yunfu 527200,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2022年第24期8728-8734,共7页世界临床病例杂志

基　　金：Supported by Natural Science Foundation of China,No.81901250;Natural Science Foundation of Guangdong Province,No.2019A1515010104 and No.2022A1515012540;High-level Hospital Construction Project of Guangdong Provincial People’s Hospital,No.DFJH201924;Science and Technology Program of Guangzhou,No.202002030128.

摘　　要：BACKGROUND The skull and dura are uncommon sites for the metastasis of hepatocellular carcinoma(HCC).Spontaneous acute epidural hematoma(AEDH)is also very rare.We report here a spontaneous AEDH secondary to skull and dural metastasis of HCC.This case is extremely rare.CASE SUMMARY A 48-year-old male patient with a history of HCC developed unconsciousness spontaneously.Head computed tomography showed"a huge AEDH in the left parietal and occipital region with osteolytic destruction of the left parietal bone.Emergent operation was performed to evacuate the hematoma and resect the lesion.Pathological study revealed that the lesion was the metastases from HCC.The patient died of lung infection,anemia,and liver failure 3 wk after operation.CONCLUSION Spontaneous AEDH caused by hepatocellular carcinoma(HCC)dural and skull metastases is extremely rare,the outcome is poor.So,early diagnosis is important.If the level of AFP does not decrease with the shrinkage of intrahepatic lesions after treatment,it is necessary to be alert to the existence of extrahepatic metastases.Since most of the patients had scalp and bone masses,physicians should pay attention to the patient's head palpation.Once a patient with the history of HCC had sudden neurological dysfunction,the possibility of spontaneous AEDH caused by the skull and dura mater metastases should be considered.Since hemorrhage is common in the skull HCC metastases,for patients with spontaneous AEDH accompanied by skull osteolytic lesions,it is also necessary to be alert to the possibility of HCC.For AEDH secondary to HCC metastases,early diagnosis and timely treatment are critical to improve the patients’outcomes.

关 键 词：Spontaneous acute epidural hematoma Hepatocellular carcinoma Skull and dural metastasis Case report 

分 类 号：R735.7[医药卫生—肿瘤]