Cerebral neoplasms initially presenting with massive intracerebral hemorrhage

In three patients, clinically silent brain tumors led to massive intracerebral hemorrhage. These patients represented 0.6% of 497 consecutive patients with primary or secondary brain tumors and 2.5% of 119 patients with hypertensive or spontaneous intracerebral hemorrhage. Examination by computed tomography and angiography provided no evidence suggestive of the presence of neoplasms. All three patients were surgically treated and the lesions were histologically confirmed to be metastatic bronchogenic carcinoma, metastatic clear-cell carcinoma and low-grade astrocytoma, respectively.