BACKGROUND: Malignant disease metastasizing to the cranial dura is rare.
Dural metastases manifesting as a subdural fluid collection and presenting as a chronic subdural hematoma is an uncommon entity with unknown pathophysiology.
CASE DESCRIPTION: We present a patient with known prostate cancer metastasizing to the cranial dura masquerading as a chronic subdural hematoma. The patient presented with bilateral subdural collections manifesting with confusion and dysphasia. Initial drainage of the larger, symptomatic left side improved only temporarily patient's symptoms. A second drainage of the collection was performed on the same side 5 days later and dural biopsies taken during the same procedure revealed prostate metastases. The patient improved slowly and was discharged to a hospice for palliative care management.
CONCLUSIONS: Prostate dural metastases should be suspected in patients with known prostate cancer presenting with a subdural collection in the absence of cranial trauma. If decision to drain the subdural collection is taken, then biopsies can be taken the same time as they can pose a diagnostic challenge.
Boukas A, Sunderland GJ, Ross N. Are you the author?
Department of Neurosurgery, Regional Neurosciences Centre, Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.
Reference: Surg Neurol Int. 2015 Feb 19;6:30.