Clinical analysis of 32 cases of brain tumor coexisted with intracranial aneurysms

Abstract

Objective To summarize the clinical features, treatment, and prognosis of brain tumor coexisted with intracranial aneurysms in order to improve diagnosis and treatment of this disease. Methods The clinical data of 32 patients with coexistence of brain tumors and intracranial aneurysms treated at the First Affiliated Hospital of Fujian Medical University, between July 2003 and June 2014 were retrospectively reviewed. There were 11 males and 21 females in all 32 cases[range from 29 to 74 years, average age(54.5±11.6) years]. There were 23 meningiomas, 6 pituitary adenomas, 1 dermoid cyst, 1 epidermoid cyst, and 1 glomus jugulare tumor. And there were 35 intracranial aneurysms in total, including 17 internal carotid artery aneurysms, 8 middle cerebral artery aneurysms, 5 anterior communicating artery aneurysms, 2 anterior cerebral artery aneurysms, 2 posterior communicating artery aneurysms, and 1 basilar artery aneurysm. In 32 cases, 23 presented with symptoms of brain tumors, 5 with symptoms of intracranial aneurysms, and 4 with no symptoms. Surgical intervention was performed in 27 patients, including simple tumor resection in 17 patients, only aneurysmal clipping in 5 patients, a combination of tumor resection and aneurysmal clipping in 4 patients, aneurysm and tumor embolization with subsequent tumor resection in 1 patient. Four patients underwent conservative treatment, and 1 patient gave up treatment. Results Thirty patients were followed with an average follow-up time being 2.5 years(ranged from 2 months to 11 years). During the follow-up period, 2 patients with conservative treatment had no clinical symptoms, and CT examination showed no bleeding. In 27 patients with surgery treatment, tumor recurrence without aneurysmal rupture occurred in 2 patients, and favourable outcomes were found in the remaining patients. Conclusions Meningiomas are the most common type in patients with coexistence of brain tumors and intracranial aneurysms, and patients frequently presented with symptoms of brain tumors. DSA or CTA should be routinely performed before surgery for patients with brain tumors. For confirmed patients, planning appropriate and individualized treatment should be based on the first symptom, the size of the brain tumors and aneurysms, the relative position of both lesions, aneurysm rupture risks, and other specific conditions. Key words: Brain neoplasms; Intracranial aneurysm; Neoplasms/Surgical; Prognosis