1988 Volume 28 Issue 4 Pages 398-403
Two cases of neoplastic aneurysm due to cerebral metastasis of choriocarcinoma are described. One patient, a 28-year-old female, complained of sudden onset of headache, nausea, and vomiting. On admission there were no neurological deficits. A lumbar puncture yielded xanthochromic cerebrospinal fluid. Right carotid angiography revealed posterior circulation through the primitive trigeminal artery and a small aneurysmal shadow in a peripheral branch of the left posterior cerebral artery. Left occipital craniotomy was performed. Subdural and intracerebral hematomas were evacuated. The second patient was a 32-year-old Thai housewife who complained of headache, nausea, and vomiting 5 days after a right upper lobectomy for a lung tumor. Computed tomography showed a small high-density area in the right occipital lobe. There was no neurological deficit or nuchal stiffness. Right carotid angiography revealed three small aneurysms in the peripheral branches of the middle cerebral artery. Partial right occipital lobectomy and evacuation of a hematoma were performed. Postoperative angiography performed after cancer chemotherapy had been administered three times showed disappearance of the aneurysmal shadows. The patient died of rebleeding 5 months after the onset of neurological symptoms. In both cases the diagnosis of choriocarcinoma was histologically established.
To data, only 11 cases of neoplastic aneurysm due to choriocarcinoma have been reported, and none involved the posterior circulation nor was associated with the primitive trigeminal artery. Disappearance of neoplastic aneurysms on angiograms obtained after chemotherapy is also rare.
