Shiying Gai1, Nan Lv2, Qi Zhang2, Qiao Zuo2, Jianmin Liu2, Qinghai Huang3. 1. Department of Neurosurgery, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China. 2. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China. 3. Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China. Electronic address: ocinhqh@163.com.
Abstract
OBJECTIVE: We present a case of multiple myxoma-related intracranial aneurysms and reviewed the recent relevant literature to investigate their natural course and develop a reasonable treatment algorithm. METHODS: We have reported a new case of multiple myxoma-related intracranial aneurysms and performed a search of current studies (2001 to the present) in PubMed. The keywords used were as follows (single words or combinations): neoplastic aneurysm, oncotic aneurysm, aneurysm, and myxoma. Only patients with multiple aneurysms resulting from cardiac myxoma and with adequate follow-up information pertinent to the analysis were included. RESULTS: A total of 41 patients, including our present patient, were studied. Of the 41 patients, 28 had received conservative treatment as the primary choice. Most lesions (n = 22) were stable during follow-up, except for 3 in which aneurysm evolution was observed. A total of 8 patients had undergone microsurgery, including aneurysm resection in 3, aneurysm clipping in 2, clipping followed by resection in 2, and aneurysm trapping in 1. Endovascular treatment was performed in 2 patients. Radiation therapy was used in 1 patient, and the parent artery proved to be occluded at the 1-year follow-up examination. A combination of chemotherapy and microsurgery was used in 1 patient. All the cases that had been managed aggressively were stable during further follow-up. CONCLUSION: The prognosis was good for most patients with multiple myxoma-related intracranial aneurysms, and most myxoma-related aneurysms were stable. Conservative treatment and routine follow-up are recommended for most patients. However, for patients with evolving or ruptured aneurysms, invasive treatment, including open surgery and endovascular treatment, should be considered.
OBJECTIVE: We present a case of multiple myxoma-related intracranial aneurysms and reviewed the recent relevant literature to investigate their natural course and develop a reasonable treatment algorithm. METHODS: We have reported a new case of multiple myxoma-related intracranial aneurysms and performed a search of current studies (2001 to the present) in PubMed. The keywords used were as follows (single words or combinations): neoplastic aneurysm, oncotic aneurysm, aneurysm, and myxoma. Only patients with multiple aneurysms resulting from cardiac myxoma and with adequate follow-up information pertinent to the analysis were included. RESULTS: A total of 41 patients, including our present patient, were studied. Of the 41 patients, 28 had received conservative treatment as the primary choice. Most lesions (n = 22) were stable during follow-up, except for 3 in which aneurysm evolution was observed. A total of 8 patients had undergone microsurgery, including aneurysm resection in 3, aneurysm clipping in 2, clipping followed by resection in 2, and aneurysm trapping in 1. Endovascular treatment was performed in 2 patients. Radiation therapy was used in 1 patient, and the parent artery proved to be occluded at the 1-year follow-up examination. A combination of chemotherapy and microsurgery was used in 1 patient. All the cases that had been managed aggressively were stable during further follow-up. CONCLUSION: The prognosis was good for most patients with multiple myxoma-related intracranial aneurysms, and most myxoma-related aneurysms were stable. Conservative treatment and routine follow-up are recommended for most patients. However, for patients with evolving or ruptured aneurysms, invasive treatment, including open surgery and endovascular treatment, should be considered.