Search

A subdural hematoma (SDH) is usually traumatic in etiology. Non-traumatic instances of SDH are uncommon, and are rarely due to metastases involving the dura. We report a 68-year-old male patient with a one day history of, not communicating and not mobilizing and a 2 weeks history of generalized body weakness. A computed tomography (CT) scan revealed a left sided hypo-dense subdural collection. A diagnosis of left sided chronic subdural hematoma (SDH) was made. Burr hole drainage of the hematoma was performed. Intra- operatively, liquefied blood was drained and a thick dura with reddish material infiltrating the dura was noted. A specimen of the dura was submitted for histology and revealed metastatic carcinoma, confirmed at immunohistochemistry to be of prostatic origin. Conclusion: Metastatic disease should be considered when there is a chronic subdural hematoma with no history of trauma and an unusual dural appearance on imaging.

Neurofibromatosis type 1 (NF1) is an autosomal dominant condition affecting approximately 1 in 3000 live births. The manifestations of this condition are extremely variable, even within families, and genetic counseling is consequently difficult with regard to prognosis. Individuals with NF1 are acknowledged to be at increased risk of malignancy. Several studies have previously attempted to quantify this risk, but have involved relatively small study populations. Soft tissue tumors represent a heterogeneous group of mesenchymal and neural lesions. We report a case of giant scalp Fibrosarcoma of the scalp in patient with neurofibromatosis type I without intracranial extension, in a 35 year old female which was excised completely along with the involved overlying skin, and reconstruction was done to cover the defect using trapezius flap and split thickness skin graft from the right thigh. She is doing well after treatment and is in regular follow up while awaiting further management by the oncologists.