Frontiers in Oncology (Jul 2021)

Atorvastatin Plus Low-Dose Dexamethasone May Be Effective for Leukemia-Related Chronic Subdural Hematoma but Not for Leukemia Encephalopathy: A Report of Three Cases

  • Jiangyuan Yuan,
  • Jiangyuan Yuan,
  • Ying Li,
  • Ying Li,
  • Xuanhui Liu,
  • Xuanhui Liu,
  • Meng Nie,
  • Meng Nie,
  • Weiwei Jiang,
  • Weiwei Jiang,
  • Yibing Fan,
  • Yibing Fan,
  • Tangtang Xiang,
  • Tangtang Xiang,
  • Hanhua Wang,
  • Hanhua Wang,
  • Wei Quan,
  • Wei Quan,
  • Chuang Gao,
  • Chuang Gao,
  • Jinghao Huang,
  • Jinghao Huang,
  • Shuo An,
  • Shuo An,
  • Yongxin Ru,
  • Qiufan Zhou,
  • Jianning Zhang,
  • Jianning Zhang,
  • Rongcai Jiang,
  • Rongcai Jiang

DOI
https://doi.org/10.3389/fonc.2021.628927
Journal volume & issue
Vol. 11

Abstract

Read online

We are not aware of any reports regarding conservative treatment for leukemia-related chronic subdural hematoma (CSDH). We report our experience with 3 men who were admitted with subdural masses and abnormal leukocyte counts. In two patients, leukemia and CSDH were confirmed on the basis of medical records, mild head trauma, and neuroimaging features. Both patients experienced reduced CSDH and neurological symptoms after receiving atorvastatin (20 mg/day) plus low-dose dexamethasone. However, this combined conservative treatment was ineffective in the third patient, who was diagnosed as having leukemia and showed an increased hematoma volume after two weeks of therapy. Magnetic resonance imaging findings suggested dural metastasis, which prompted a switch from statin-based conservative treatment to chemotherapy. Complete remission of the leukemia and resolution of the subdural mass were observed after chemotherapy, which supported a diagnosis of leukemia encephalopathy. The 5-month follow-ups did not reveal CSDH relapse in all 3 cases. Thus, atorvastatin-based conservative treatment may be effective for leukemia-related CSDH but not for leukemia encephalopathy.

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