[Chronic encapsulated intracerebral hematoma due to metastatic brain tumor: a case report].

Intracerebral hemorrhage from a brain tumor can mask the cause of bleeding, confuse the diagnosis, and affect the treatment and prognosis. This type of hemorrhage is generally regarded as a rapidly progressive, fulminating disease, sudden in onset, with the outcome being death or profound neurological deficits. Such hemorrhages are demonstrated by CT scan as intracerebral high density areas. Intracerebral hematomas producing chronic neurological disability and chronic intracerebral hematomas are rarely reported. We experienced a case of chronic intracerebral hematoma due to metastatic brain tumor. The patient was a 60-year-old female, and the initial symptoms were mild headache followed by right homonymous hemianopsia. The intracranial lesion was demonstrated by CT scan as an oval-shaped low density area (3 X 4.5 cm) with a ring enhancement in the left occipital lobe. MRI showed marked high intensity by short SE and long SE in the left occipital lobe. A left occipital craniotomy was performed. No tumor could be seen macroscopically except for an old encapsulated hematoma. Aspiration of the liquid hematoma and biopsy of the wall of the hematoma were done. A histological examination revealed an adenocarcinoma. Spontaneous bleeding from brain tumors was reviewed, and diagnostic problems were discussed.