Intracerebral Hemorrhage Caused by a Neoplastic Aneurysm From Pleomorphic Lung Carcinoma

• Published in: Neurologia medico-chirurgica Vol. 49; no. 1; pp. 33 - 36
• Main Authors: Nomura, Ryutaro, Yoshida, Daizo, Kim, Kyongsong, Kobayashi, Shiro, Teramoto, Akira
• Format: Journal Article
• Language: English
• Published: Japan THE JAPAN NEUROSURGICAL SOCIETY 2009
• Subjects: Aneurysm, Ruptured - complications; Aneurysm, Ruptured - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - secondary; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - etiology; Coma - etiology; Fatal Outcome; Frontal Lobe - pathology; Humans; Intracranial Aneurysm - complications; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - pathology; Lung Neoplasms - pathology; Male; Middle Aged; Neoplasm Invasiveness; Paresis - etiology; Parietal Lobe - pathology; Radiography; Rupture, Spontaneous; Supratentorial Neoplasms - complications; Supratentorial Neoplasms - diagnostic imaging; Supratentorial Neoplasms - pathology; Supratentorial Neoplasms - secondary
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.49.33

A 61-year old man presented with an extremely rare neoplastic cerebral aneurysm caused by brain metastasis from pleomorphic lung carcinoma manifesting as intracerebral hematoma and sudden onset of semicoma. Computed tomography demonstrated huge intracerebral hemorrhage in the left cerebral hemisphere, which had collapsed into the lateral ventricle. Cerebral angiography disclosed a fusiform aneurysm in the periphery of the left middle cerebral artery(approximately 2mm diameter). Resection of the aneurysm and removal of the hematoma were performed. Histological examination revealed that the aneurysm walls were invaded by pleomorphic carcinoma. The present case indicates that neoplastic cerebral aneurysm may be the cause of intracerebral hemorrhage in patients with pleomorphic lung carcinoma. [Introduction]Metastatic brain tumors are frequently the cause of intracerebral hemorrhage. 12,13,20) However, intracerebral hemorrhage from a neoplastic cerebral aneurysm is rare. 1,14,19) Neoplastic aneurysms are predominantly caused by metastasis of cardiac myxoma3,9,15,16,18) or choriocarcinoma4,6,8,11,17,21,24)to the brain.