Primary Intracranial Sarcoma Presenting as Chronic Subdural Fluid Collections in a Child

Primary intracranial sarcoma masquerading as a chronic subdural haematoma: illustrative case and review of an unusual phenomenon

It is very unusual for a primary intracranial malignancy to present as a chronic subdural hematoma. This case report describes one such case in a 3-year-old girl who presented with raised intracranial pressure following a mild head injury. Imaging of her brain revealed bilateral chronic subdural hematomas with an enhancing subdural mass and multiple nodular lesions infiltrating the brain parenchyma. She underwent a craniotomy, drainage of the subdural collections and resection of the subdural mass. Histopathology revealed an undifferentiated sarcoma, and she was referred for adjuvant therapy. This case underlines the importance of evaluating paediatric subdural collections for a possible underlying malignancy, even in the background of a preceding head injury. The cause-effect relationship of sarcomas with subdural collections remains unclear because of the scarcity of available literature on the subject.

Skull angiosarcoma associated with a calcified chronic subdural hematoma

Angiosarcoma is an uncommon, aggressive endothelial-cell tumor that usually affects the skin, and involvement of the skull is rare. Here, we describe a case of skull angiosarcoma associated with a calcified chronic subdural hematoma (CSDH). HIGHLIGHTS A very rare case of skull angiosarcoma associated with a calcified chronic subdural hematoma is presented. An asymptomatic subdural hematoma with an atypical history and radiological features should prompt further investigation. Contrast MRI images should to be obtained early to differentiate a subdural hematoma from other pathologies.