Etoposide/carboplatin chemotherapy for the treatment of metastatic myxomatous cerebral aneurysms

Branscheidt, Meret; Frontzek, Karl; Bozinov, Oliver; Valavanis, Anton; Weller, Michael; Wegener, Susanne

doi:10.1007/s00415-014-7281-3

Cited by 17 publications

(12 citation statements)

References 9 publications

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“…38 Another method that is still controversial is to treat enlarging aneurysms, which are not good candidates for surgical or endovascular treatment, with chemotherapeutics to stabilize the lesions. 44…”

Section: Discussionmentioning

confidence: 99%

The dynamic natural history of cerebral aneurysms from cardiac myxomas: A review of the natural history of myxomatous aneurysms

et al. 2018

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We describe two contrasting patients with multiple cerebral aneurysms and a previous history of resected cardiac myxomas with no cardiac recurrence on follow-up echocardiography. Both patients presented with stroke- like symptoms; one with a left visual defect and the other with right hemiplegia. Magnetic resonance imaging of the brain of both patients showed the presence of multiple cerebral aneurysms that was later confirmed on conventional angiography. Both patients’ aneurysms were managed conservatively. Serial angiograms were performed during their follow-up, which spanned several years. One patient’s aneurysms remained static while the evolution of the other patient’s aneurysms displayed a dynamic quality with some increasing in size while others diminished. This is the first description in which some aneurysms progressed while others regressed simultaneously in the same patient. Aneurysms in patients with a history of cardiac myxoma can be active years after primary tumor resection and it is difficult to predict how they will develop. We reviewed the literature of all patients with multiple myxomatous aneurysms who were treated conservatively to better understand the natural history of this rare disease. Long-term follow-up of these patients may be necessary.

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Section: Discussionmentioning

confidence: 99%

The dynamic natural history of cerebral aneurysms from cardiac myxomas: A review of the natural history of myxomatous aneurysms

et al. 2018

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“…The results from chemotherapy have been equivocal (31), but evidence has shown that the combination of radiotherapy and chemotherapy is useful for the treatment of myxo ma metastasis, thereby reducing the likelihood of formation of myxomatous aneurysms (32)(33)(34). Other investigators have suggested that despite independent reports of microsurgical resection/endovascular intervention, chemotherapy, and radiotherapy for the treatment of cardiac myxomatous intracranial aneurysms, there is still a lack of clear guidelines (35). In this case, the presence of intracranial aneurysm associated with cardiac myxomatosis and a small amount of bleeding from the left middle cerebral artery aneurysm suggested that there might be irreversible damage to the artery wall structure.…”

Section: Discussionmentioning

confidence: 99%

Delayed multiple intracranial aneurysms caused by left atrial myxoma: a case report and literature review

Wang¹,

Wang²,

Hu³

et al. 2022

Transl Pediatr

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Intracranial aneurysm may appear even after the removal of the cardiac myxoma. However, the pathogenesis and treatment of such aneurysm lesions are not clear. The study aimed to explore the clinical and imaging manifestation, hypothetical pathogenesis, and therapy in one case of left atrial myxoma causing multiple intracranial aneurysms. A 14-year-old male displayed a 3-hour history of episodic loss of consciousness and right hemiplegia after a leapfrog-like movement. The myxoma was diagnosed by a combination of clinical examination, leading to the diagnosis of mitral dynamic obstruction with a Grade III mitral diastolic murmur and tumor plop; magnetic resonance imaging, revealing multiple ischemic sites in both semi-oval centers; and transthoracic echocardiography, demonstrating a mitral valve obstruction.The myxoma was removed surgically; however, computed tomography angiography showed multiple intracranial aneurysms in both middle cerebral arteries 18 months after resection of the atrial myxoma. After conservative treatment, the patient had no neurological dysfunction symptoms for 5 years after myxoma resection. His condition is relatively stable. In conclusion, resection of the atrial myxoma may eliminate the early neurological symptoms, but it cannot ensure the nonoccurrence of delayed intracranial aneurysms. The neoplastic process theory was favored for explaining the aneurysm development in this case. According to the specific conditions of the patient, a combination of open surgery, chemotherapy, radiotherapy, and coil embolization is recommended.

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“…Because of the fusiform shape, coil embolization with stenting could be necessary 7) . There remains much debate regarding the possibility that chemotherapeutics can stabilize myxomatous aneurysms when surgery or endovascular procedure is not possible 3) . In conclusion, our case shows that surgical resection with bypass surgery is a useful option for the treatment of cerebral myxomatous aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Myxomatous Aneurysm Treated by M2-M2 Bypass: A Case Report

Yoo

Chung

Ahn

2018

Nerve

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Intracranial aneurysms associated with atrial myxoma have been reported and termed "myxomatous aneurysms." We present a case of cerebral myxomatous aneurysms treated by M2-M2 bypass surgery. A 20-year-old woman was admitted for evaluation and management of multiple cerebral aneurysms found incidentally. She had a history of right middle cerebral artery (MCA) territory infarction with MCA total occlusion. At that time, cardiac myxoma was incidentally found and surgically removed. In cerebral angiography, multiple cerebral aneurysms were identified. Among them, a right MCA fusiform aneurysm was the largest, with a diameter of 19.5 mm; notably, this developed at the site of previous MCA occlusion. Through surgical exploration, an MCA bifurcation aneurysm was observed, with a permanently occluded inferior trunk toward the temporal lobe. M2-M2 end-to-end anastomosis with resection of aneurysm was successfully performed, and biopsy showed dilation and thickening of the aneurysmal wall without any evidence of tumor invasion. The outcome of this case shows that surgical resection with bypass surgery is a useful option for the treatment of cerebral myxomatous aneurysms.

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Etoposide/carboplatin chemotherapy for the treatment of metastatic myxomatous cerebral aneurysms

Abstract: (2014). Etoposide/carboplatin chemotherapy for the treatment of metastatic myxomatous cerebral aneurysms. Journal of Neurology, 261(4):828-830.

Cited by 17 publications

References 9 publications

The dynamic natural history of cerebral aneurysms from cardiac myxomas: A review of the natural history of myxomatous aneurysms

The dynamic natural history of cerebral aneurysms from cardiac myxomas: A review of the natural history of myxomatous aneurysms

Delayed multiple intracranial aneurysms caused by left atrial myxoma: a case report and literature review

Cerebral Myxomatous Aneurysm Treated by M2-M2 Bypass: A Case Report

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