Brain tumors with hemorrhage

Various types of brain tumors may cause hemorrhage. The purpose of the stud y was to examine the clinical relevance of tumor hemorrhage and the hemorrh agic mechanism from the pathologic viewpoint. We retrospectively reviewed 7 61 consecutive brain tumor cases according to clinical, operative, and path ologic records. Pituitary adenomas and recurrent tumors were excluded. Twen ty-seven patients (17 men and 10 women, mean age, 50 years) with brain tumo r hemorrhage were identified, resulting in an incidence of 3.5%. In 632 cas es of primary brain tumors, there were 15 cases with hemorrhage, resulting in an incidence of 2.4%. There were 12 cases of brain tumor hemorrhage in 1 29 patients with metastatic tumors, for an incidence of 9.3%. Among hemorrh agic cases, 63.0% of patients presented with acute onset of clinical deteri oration. In 72.7% of gliomas with hemorrhage, hematoma appeared within the tumor, and 75% of metastatic brain tumors with hemorrhage were intracerebra l hemorrhages around the borders of the tumors. The highest hemorrhage rate for primary brain tumors occurred in pilocytic astrocytomas, while the hig hest hemorrhage rates in secondary tumors occurred in metastatic thyroid pa pillary carcinomas and hepatocellular carcinomas. In our pathology study, i ncreasing intratumor vascularization with dilated, thin-walled vessels and tumor necrosis were the most important mechanisms of hemorrhage.