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Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
06:44

Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging

Published on: June 7, 2020

[A case of encapsulated intracerebral hematoma mimicking metastatic brain tumor]

Arata Tomiyama1, Kazuya Aoki, Kenichiro Sato

  • 12nd Department of Neurosurgery, Toho University Ohashi Medical Center, Tokyo, Japan.

No Shinkei Geka. Neurological Surgery
|August 17, 2006
PubMed

Insights

Encapsulated intracranial hematoma (EIH) can mimic brain tumors, even with advanced imaging. This case highlights the importance of considering EIH in patients with suspected brain metastases.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Encapsulated intracranial hematoma (EIH) is a rare intracranial hemorrhage variant.
  • EIH is frequently misdiagnosed as a malignant brain tumor preoperatively.

Observation:

  • A 77-year-old male with prostate cancer presented with hemiparesis and a right precentral gyrus mass with edema.
  • Head CT, MRI, and Digital Subtraction Angiography (DSA) suggested a metastatic brain tumor.
  • Thallium-201 SPECT (Tl-201 SPECT) showed high L/N and L/E ratios, further supporting a tumor diagnosis.

Findings:

  • Postoperative pathological examination confirmed EIH, with no tumoral components or vascular malformations.
  • Despite advanced imaging like DSA and Tl-201 SPECT, the EIH presented with tumor-like characteristics.
  • This case underscores the diagnostic challenges posed by EIH.

Implications:

  • Neurosurgeons and radiologists should consider EIH in the differential diagnosis of hemorrhagic brain masses.
  • Even imaging modalities typically used to distinguish tumors may yield ambiguous results in EIH cases.
  • Increased awareness and consideration of EIH can prevent misdiagnosis and guide appropriate management.

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