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A Case of Primary Fibrosarcoma Caused by Spontaneous Intracerebral Hematoma Shigetaka ANEGAWA 1 , Ryuichiro TORIGOE 1 , Takashi HAYASHI 1 , Yoko YAMASHITA 2 , Yasuhiro FURUKAWA 3 1Department of Neurosurgery, Institute of Neurosciences, St. Mary's Hospital 2Divisions of Laboratorial Examination, Saiseikai Fukuoka General Hospital 3Divisions of Laboratorial Radiology, Saiseikai Fukuoka General Hospital Keyword: Angiography , CT scan , Operation , Primary fibrosarcoma , Spontaneous intracerebral hematoma pp.485-490
Published Date 1991/5/10
DOI https://doi.org/10.11477/mf.1436900266
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Abstract

A rare case of repeated intracerebral hematoma associated with an intracerebral fibrosarcoma is re-ported.

A 43-year-old man was referred to our clinic with headache and vomiting of sudden onset. On admission,he was lethargic. CT revealed a huge intracerebral hematoma in the left temporal lobe with midline shift. Angiography failed to demonstrate any evidence of an intracranial tumor. An operation was performed under the diagnosis of an idiopathic cerebral hematoma. The postoperative course was uneventful and he was dis-charged without any deficits except for a left upper quadrant homonymous hemianopia.

Four and a half months after the first operation, he was readmitted to our clinic with the same symptoms as he had at the first admission. Neuroradiological ex-amination again revealed an intracerebral hematoma in the left temporal lobe. At operation, a pinkish-gray dis-colored mass at the hematoma wall was found. An in-traoperative histological examination of the mass indi-cated a malignant tumor and the tumor was totally re-moved. However the patient did not recover from the severe neurological deficits and died 3 months after the second surgery. Histological examinations of the tumor demonstrated a typical fibrosarcoma.

Intracerebral primary fibrosarcoma with hemorrhage is quite rare. In such a case with a large hematoma, the presence of a tumor may be obscured on CT scan and angiography. Detailed observation of the hematoma wall using an operating microscope should be per-formed to allow a correct diagnosis.


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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