Neoplastic cerebral aneurysm from metastatic tumor: A systematic review of clinical and treatment characteristics

• Neoplastic cerebral aneurysms from cardiac myxoma were probably multiple.
• Neoplastic cerebral aneurysms from choriocarcinoma and other tumors were single.
• Neoplastic cerebral aneurysms from choriocarcinoma presented with hemorrhage.
• The prognosis is quite good in neoplastic cerebral aneurysms from cardiac myxoma.
• Neoplastic cerebral aneurysms from malignant tumors have poor outcomes.

ObjectiveNeoplastic cerebral aneurysm (NCA) is a very rare event. The authors aimed to characterize the clinical and treatment details of this poorly defined entity.Materials and methodsA computerized systematic literature search was performed in PubMed, Medline, Web of Science, Cochrane Library, Embase, Google Scholar, Science Direct and Scopus. Keywords used were as follows: “aneurysm”; “myxoma”; “choriocarcinoma”; “oncotic aneurysm”; “neoplastic aneurysm”. Only reports with cerebral aneurysm resulting from metastatic tumor and contained adequate clinical information pertinent to the analysis were included. Clinical and treatment characteristics were analyzed.ResultsNinety-two studies reporting 96 cases of neoplastic cerebral aneurysm were identified. NCA from cardiac myxoma accounted for 60.4%, while NCA from choriocarcinoma and other tumors accounted for 26.1% and 13.5%, respectively. The rates of intracranial hemorrhages were 19.6% in NCA from myxoma, 100% in NCA from choriocarcinoma, and 84.6% in NCA from other tumors. 75.9% of NCA from myxoma were managed conservatively, 92% of NCA from choriocarcinoma were treated by surgery and/or chemotherapy, and 69.2% of NCA from other tumors were treated by surgery with or without chemotherapy. The mortality rates were 11.4% in NCA from myxoma, 60.9% in NCA from choriocarcinoma, and 92.3% in NCA from other tumors. According to a multiple logistic regression model, “pathology (P = 0.002)” is significantly correlated with outcome.ConclusionsNeoplastic cerebral aneurysms are usually complicated with cardiac myxoma, choriocarcinoma and lung carcinoma. NCA from cardiac myxoma were probably multiple and rarely associated with intracranial hemorrhage, while the majority of NCA from choriocarcinoma and other tumors were single and presented with intracranial hemorrhage. The prognosis is quite good in NCA from cardiac myxoma, while NCA from malignant tumors were associated with poor outcome.