Non-myxoma neoplastic cerebral aneurysms: A systematic review

Non-myxoma neoplastic cerebral aneurysms: A systematic review

•Non-myxoma neoplastic cerebral aneurysms have worse outcomes than myxomas.•Non-myxoma pathologies: choriocarcinoma (58%); lung cancer (20.0%); other (22%).•90-day survival rates: choriocarcinoma (60%); lung cancer (28.6%); other (14.3%).•180-day survival rates: choriocarcinoma (52%); lung cancer (1...

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Published in:Journal of clinical neuroscience Vol. 82; no. Pt B; pp. 200 - 206
Main Authors: Nussbaum, Eric S., Torok, Colin M., Khalil, Zena M., Pederson, John M.
Format: Journal Article
Language:English
Published: Scotland Elsevier Ltd 01-12-2020
Subjects:
Adult
Brain Neoplasms - complications
Brain Neoplasms - secondary
Cerebral Hemorrhage
Choriocarcinoma
Choriocarcinoma - complications
Choriocarcinoma - pathology
Female
Humans
Intracranial Aneurysm - diagnosis
Intracranial Aneurysm - etiology
Intracranial Aneurysm - pathology
Lung Neoplasms - complications
Male
Metastasis
Myxoma
Neoplastic aneurysm
Pregnancy
Prognosis
Subarachnoid Hemorrhage
Neoplastic aneurysm
Choriocarcinoma
Metastasis
Subarachnoid hemorrhage
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Summary:•Non-myxoma neoplastic cerebral aneurysms have worse outcomes than myxomas.•Non-myxoma pathologies: choriocarcinoma (58%); lung cancer (20.0%); other (22%).•90-day survival rates: choriocarcinoma (60%); lung cancer (28.6%); other (14.3%).•180-day survival rates: choriocarcinoma (52%); lung cancer (14.3%); other (0%). Neoplastic cerebral aneurysms (NCAs) are highly rare lesions characterized by invasion of cancerous cells within the wall of an artery leading to aneurysm formation. While NCAs caused by myxomas are well characterized in the clinical literature, rarer etiologies have also been reported and are typically associated worse clinical outcomes. We performed the first PRISMA-compliant systematic literature review of true, non-myxoma neoplastic cerebral aneurysms using the PubMed/MEDLINE, Embase, Scopus, and Google Scholar databases. Data of interest included age, sex, aneurysm size, number of aneurysms, aneurysm location, neoplasm type, aneurysm treatments, cancer treatments, risk of rupture, intracerebral hemorrhage prevalence, subarachnoid hemorrhage prevalence, and survival at 90 and 180 days. A total of 50 studies met our inclusion criteria. The mean age of the patient population was 37.4 years (SD: ±16.8) and had an overall female preponderance (39/50, 78%). Of these NCA cases, 29/50 (58.0%) were choriocarcinomas, 10/50 (20.0%) were related to lung cancer, and 11/50 (22.0%) had other origins of variable pathologies. 90-day survival rates were 60.0% (15/25) for choriocarcinomas, 28.6% (2/7) for the lung cancer group, and 14.3% (1/7) for the other origins group. 180-day survival rates were 52.0% (13/25) for the choriocarcinoma group, 14.3% (1/7) for the lung cancer group, and 0% (0/7) for the other origins group. Prognosis of NCA patients ultimately depends on the course of disease progression and cancer management. Further research is needed to better understand optimal treatment modalities for patients with NCAs.
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ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2020.11.010