Death caused by undiagnosed primary intracranial neoplasmas - an autopsy study

Aim. The purpose of this study was to find the incidence of death caused by undiagnosed intracranial tumors. Methods. Autopsy material of the Institute of Forensic Medicine in Belgrade, from 1990 to 2004, was analyzed. The cases in which the cause of death is undiagnosed brain tumor have been extracted. Results. Brain tumors have caused death in 10 cases, of that 7 persons had benign tumors and three malignant and that was 3.9% of 259 indistinct natural deaths caused by pathological disorders of the brain. Of those three cases of malignant neoplasmas of the brain, one has been proven by pathohistological analysis to be an astrocytome of third grade malignity while the second case was a glioblastome. The histological type of tumor in the third case could not be determined because of big necrotic changes in the histological preparation. In the group of benignant tumors leading to death, five cases were menigothel tumors (meningiomas), and two cases were indistinct histogenesis (hemangioglioblastomas). Conclusion. The incidence of sudden death caused by undiagnosed primary intracranial tumors is extremely low. In every case with a susception to intracranial pathology a multidisciplinary approach that includes a total autopsy with thorough documentation and neuropathological tests is necessary.