Skull metastasis of hepatocellular carcinoma associated with acute epidural hematoma: A case report

BACKGROUND. Although epidural hematoma is well documented in trauma patients, its association with other etiologies, such as neoplasms, is not widely known. Here the authors report a case of acute epidural hematoma that originated from a metastatic hepatocellular carcinoma (HCC) in the skull. CASE DESCRIPTION. A 70-year-old male was admitted to our hospital with left-sided hemiparesis. Preoperative computed tomography (CT) revealed a lenticular high-density area adjacent to the right parietal bone, consistent with an acute epidural hematoma. A subsequent magnetic resonance image (MRI) showed a skull tumor adjacent to the epidural hematoma. Removal of the tumor and evacuation of the hematoma were performed and the pathological diagnosis was metastatic HCC. Postoperatively, the patient gradually recovered but he died of pneumonia 2 months later. CONCLUSION. This report represents an additional example of a rare case of metastatic skull tumor associated with acute epidural hematoma. The authors suggest that metastatic skull tumors may be one of the important differential diagnoses in patients with acute epidural hematoma. Copyright (C) 2000 Elsevier Science Inc.