Brain metastases of a malignant fibrous histiocytoma presenting as an acute cerebral hemorrhage

Intracranial metastases from malignant fibrous histiocytoma (MFH) are rare, particularly with associated hemorrhage. This article reports one case and presents a review of the literature on this topic. A 55-year-old man prese nted with acute drowsiness, aphasia and right homonymous hemianopsia and he miparesis. The first CT scan showed a left occipitoparietal hematoma and th e second one. nodular. contrast-enhanced lesions. He had been previously op erated on soft tissues MFH. Lung metastases developed subsequently. A crani otomy was performed with evacuation of the hematoma and total gross resecti on of the mass lesions. Microscopic examination disclosed a metastasis from a MFH. Neoangiogenesis, stimulated by angiogenic growth factors, seems to take part in this vascular, stroke-like event. Due to longer survivals of p atients harboring systemic sarcomas, these tumors should be considered in t he differential diagnosis of intracranial neoplasms, whether hemorrhagic or not. In particular, history of a previous soft tissue or heart tumor assoc iated with lung metastasis should evoke the possibility of MFH metastasis.