Metastatic choriocarcinoma with multiple neoplastic intracranial microaneurysms

Chang, In Bok; Cho, Byung Moon; Park, Se Hyuck; Yoon, Dae Young; Oh, Sae Moon

doi:10.3171/jns/2008/108/5/1014

Cited by 25 publications

(12 citation statements)

References 17 publications

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“…4) In our case, the arachnoid contained collections of necrotic and denatured tumor cell-like scars, but no malignant cells in the aneurysm wall or the arachnoid. Although the lymphocytes in the adventitia and intima of the artery did not express CD79 or CD20 immunoreactivity, we thought that the aneurysms were oncotic secondary to metastasis from the MALT lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Arterial Graft to Treat Ruptured Distal Middle Cerebral Artery Aneurysms in a Patient With Mucosa-Associated Lymphoid Tissue Lymphoma

Hasegawa

Morioka

Makino

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 60-year-old man was admitted to our hospital with sudden onset of motor aphasia, Gerstmann syndrome, and incomplete right hemiparesis one week after administration of chemotherapy for mucosaassociated lymphoid tissue (MALT) lymphoma. Computed tomography showed an intracerebral hematoma in the left subcortical area. Cerebral angiography revealed 2 aneurysms on the distal middle cerebral artery (MCA) that increased in size in the course of 2 weeks. The aneurysms were excised and a bypass placed using a superficial temporal artery (STA) graft. Histological study showed no bacteria, infiltration of inflammatory cells, or lymphoma cells in the aneurysm wall. The chemotherapy against MALT lymphoma was highly effective, so we presumed that the lymphoma cells had disappeared. The source of the distal MCA aneurysms was thought to be oncotic. Distal MCA aneurysms caused by MALT lymphoma are extremely rare. Surgical reconstruction using the STA may be effective in patients with ruptured distal MCA aneurysms if the wall is intact.

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Section: Discussionmentioning

confidence: 99%

Arterial Graft to Treat Ruptured Distal Middle Cerebral Artery Aneurysms in a Patient With Mucosa-Associated Lymphoid Tissue Lymphoma

Hasegawa

Morioka

Makino

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…Surgery is indicated in cases with massive mass effect due to intracerebral hematoma or tumor mass. Use of blood clots biopsy specimens is important for determining the etiology5,13). Suction evacuation of the hematoma may cause loss of material for histopathologic evaluation and may thus miss the opportunity for diagnosis13).…”

Section: Discussionmentioning

confidence: 99%

“…The prognosis is considered to be very poor, and metastases often develop early3). The most common sites for metastasis are the vulvo-vaginal region, the lungs, the liver and the brain3,5,9,10). The spinal metastasis of choriocarcinoma is extremely rare11).…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Spinal Cord Metastasis of Choriocarcinoma

Heon

Lee

et al. 2012

J Korean Neurosurg Soc

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The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.

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“…First, trapped neoplastic cells may form emboli in the cerebral circulation, which have a predilection for vessel wall invasion and result in aneurysms. 6) This type of aneurysm, called``neoplastic aneurysm,'' usually occurs with brain metastases of choriocarcinoma and atrial myxoma. 6,12) Second, pseudoaneurysm, due to vessel injury, may occur in patients who undergo tumor resection.…”

Section: Discussionmentioning

confidence: 99%

“…6) This type of aneurysm, called``neoplastic aneurysm,'' usually occurs with brain metastases of choriocarcinoma and atrial myxoma. 6,12) Second, pseudoaneurysm, due to vessel injury, may occur in patients who undergo tumor resection. Injury to the internal carotid artery encased by the tumor during transsphenoidal or skull base surgery often induces such pseudoaneurysms.…”

Section: Discussionmentioning

confidence: 99%

De Novo Aneurysm in the Feeding Artery of a Recurrent Malignant Glioma -Case Report-

Sasagawa

Akai

Itou

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 52-year-old man underwent resection of an oligodendroglioma in the left frontal lobe, followed by chemoradiation therapy in 1989. He presented with a de novo aneurysm arising from the feeding artery of a recurrent malignant glioma in 2009. Serial follow-up magnetic resonance imaging showed no tumor progression until 19 years after the initial diagnosis. Angiography revealed an intratumoral aneurysm of the dilated feeding artery. The recurrent tumor was resected together with the aneurysm. Histological examination revealed that the tumor was an anaplastic oligodendroglioma, and the aneurysm was encased in the tumor. Clinicians should carefully look for tumor recurrence and aneurysm formation during follow up of patients treated for malignant glioma.

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Metastatic choriocarcinoma with multiple neoplastic intracranial microaneurysms

Cited by 25 publications

References 17 publications

Arterial Graft to Treat Ruptured Distal Middle Cerebral Artery Aneurysms in a Patient With Mucosa-Associated Lymphoid Tissue Lymphoma

Arterial Graft to Treat Ruptured Distal Middle Cerebral Artery Aneurysms in a Patient With Mucosa-Associated Lymphoid Tissue Lymphoma

Intramedullary Spinal Cord Metastasis of Choriocarcinoma

De Novo Aneurysm in the Feeding Artery of a Recurrent Malignant Glioma -Case Report-

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