Cerebral Metastasis Mimicking A Subdural Hematoma in Cervical Carcinoma: A Case Report

Abstract

Objective:
To describe an unusual intracranial metastasis from cervical carcinoma that radiologically mimicked a subdural hematoma and to emphasize the diagnostic challenges associated with this presentation.
Case description:
A 58-year-old woman with previously treated poorly differentiated cervical carcinoma presented with progressive decline in consciousness, dysarthria, headache, and right-sided weakness. Contrast-enhanced computed tomography of the head demonstrated subdural-appearing lesions in the left parieto-occipital and right frontotemporal regions, accompanied by perilesional edema and an approximately eight-millimeter rightward midline shift. A lytic lesion of the left p arieto-occipital calvarium and cortical thinning of the right temporal bone raised suspicion of metastatic involvement. Because of neurological deterioration and significant mass effect, urgent craniotomy with tumor excision was performed. Histopathological examination demonstrated metastatic carcinoma, and subsequent morphological and immunohistochemical evaluation supported a diagnosis of small-cell neuroendocrine carcinoma of cervical origin.
Comments:
Intracranial metastasis should be considered in the differential diagnosis of a subdural-appearing lesion in patients with a history of malignancy, particularly when perilesional edema, bone abnormalities, or significant mass effect are present. Contrast-enhanced computed tomography is valuable for rapid emergency assessment, whereas magnetic resonance imaging may provide superior lesion characterization in clinically stable patients. Histopathological examination remains essential for establishing the definitive diagnosis.