Neoplastic Cerebral Aneurysm from Metastatic Lung Adenocarcinoma with Neuroendocrine Features

World Neurosurg. 2019 Feb:122:155-160. doi: 10.1016/j.wneu.2018.10.185. Epub 2018 Nov 3.

Abstract

Background: Neoplastic cerebral aneurysms are exceedingly rare. We describe a case of a ruptured, distal middle cerebral artery aneurysm as the presenting symptom leading to the identification of metastatic lung cancer.

Case description: The patient underwent an uncomplicated surgical trapping and ligation of the aneurysm. Histopathologic examination of the aneurysm confirmed the neoplastic cerebral aneurysm was due to a metastatic lung adenocarcinoma with neuroendocrine features. The patient subsequently underwent stereotactic radiosurgery to the resection cavity.

Conclusions: Neoplastic cerebral aneurysms are rare, and there are insufficient data to support specific guidelines for management. This case is novel as the patient received adjuvant stereotactic radiosurgery to the operative bed, as well as systemic chemotherapy, and has maintained good functional status as of last follow-up at 6 months.

Keywords: Aneurysm; Cerebral; Hemorrhage; Lung; Metastasis; Neoplastic; Radiosurgery.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung / complications*
  • Adenocarcinoma of Lung / diagnosis
  • Adenocarcinoma of Lung / pathology
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / etiology*
  • Aneurysm, Ruptured / therapy
  • Diagnosis, Differential
  • Humans
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / etiology*
  • Intracranial Aneurysm / therapy
  • Lung Neoplasms / complications*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Middle Cerebral Artery