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Small cell lung carcinoma causing epidural hematoma: case report

N E Simmons1, W J Elias, S L Henson

  • 1Department of Neurosurgery, University of Virginia, Charlottesville, USA.

Surgical Neurology
|February 10, 1999
PubMed
Summary

Small cell lung carcinoma can cause epidural hematoma through brain metastasis. This rare cause of non-traumatic epidural hematoma requires prompt diagnosis and surgical intervention for improved patient outcomes.

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Area of Science:

  • Neurology
  • Oncology
  • Neurosurgery

Background:

  • Epidural hematoma is typically caused by trauma.
  • Neoplasms are an uncommon but recognized cause of epidural hematoma.
  • Small cell lung carcinoma (SCLC) can present with central nervous system metastasis.

Observation:

  • A 67-year-old male patient with SCLC developed acute neurologic deterioration.
  • The patient presented with a large, non-traumatic parietal epidural hematoma.
  • Metastatic SCLC was identified in the scalp, muscle, bone, and dura, without gross brain invasion.

Findings:

  • Surgical evacuation of the epidural hematoma via craniotomy led to significant clinical improvement.
  • The epidural hematoma was directly attributed to a hemorrhagic metastasis from SCLC.

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  • This case highlights a rare etiology for epidural hematoma.

    • Implications:

    • Metastatic disease should be considered in the differential diagnosis of intracranial hemorrhage, including epidural hematoma.
    • Increased incidence of lung carcinoma and an aging population may lead to more cases of neoplastic epidural hematoma.
    • Prompt diagnosis and surgical intervention are crucial for managing epidural hematoma secondary to metastatic cancer, improving both acute and long-term patient outcomes.