Chronic subdural hematoma in a patient with acute myeloid leukemia and dural metastatic infiltration

Dural metastasis (pachimeningeal carcinomatosis) refers to involvement of dura mater and subdural or epidural spaces in systemic cancer. Although dural metastasis are relatively frequent in malignancies, (8-9% of patients with advanced systemic cancer in autopsy), they are rarely associated with subdural hematoma. We present the case of a 66-year-old male, refereed to the hematological unit for severe anemia of unknown cause and diagnosed as acute myeloid leukemia, developed in the 10th day from admission progressive gait disorders with marked imbalance and mental status change. A CT head scan showed a large, chronic subdural hematoma, which was surgically removed. Pathological examination of the dura and cytological examination of the subdural fluid revealed metastatic involvement of the dura, demonstrating the association of dural metastasis and chronic subdural hematoma.