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Albahrani FH, Alturaiki JA, Alahmed AY, Aljasem JM, Alshammari MM, Alali AS, Aldabbab AY, Alhelal AA, Alkhairy A. Co-occurrence of Meningioma and Intracranial Aneurysm: A Systematic Review. Cureus 2024; 16:e52919. [PMID: 38406094 PMCID: PMC10893881 DOI: 10.7759/cureus.52919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
A complete understanding of the rare neurosurgical phenomenon of co-occurring meningioma and intracranial aneurysm is important to improve the quality of life and decrease future complications in these patients. In this review, we searched the literature for cases of this rare phenomenon to highlight the most important historical, investigation, and treatment-related factors to improve the accuracy of intraoperative procedural decisions. We searched the PubMed database for case reports on this neurological rare phenomenon to create organized data for our review. Then, we extracted information from these cases and organized it in a table. We identified 19 cases in the literature. In the published studies, there was a predominance of the female sex (73.68%). The mean age of the patients was 54.11 years, with the cases relatively evenly distributed among patients in their 30s, 40s, 50s, 60s, and 70s. Posterior communicating artery aneurysm was the most common among the 19 cases. For meningioma, the frontal lobe and clinoid were the two most affected locations, and the meningothelial histopathology was the most common. Complete tumor resection and aneurysmal clipping were done for the majority of the cases (57.8%) unless there was a complication that deferred simultaneous intervention. Fortunately, most patients (78.95%) recovered completely after surgery. The coexistence of meningioma and intracranial aneurysm has a very high cure rate, postoperative symptom resolution, and a very low recurrence rate. For most cases, neuroimaging investigations are recommended for simultaneous management. This imaging can also highlight other potentially suspicious findings.
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Affiliation(s)
| | | | | | | | | | | | | | - Ali A Alhelal
- Medical School, King Faisal University, Al-Ahsa, SAU
| | - Abdu Alkhairy
- Skull Base and Vascular Neurosurgery, General Directorate of Health Affairs, Aseer, SAU
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2
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Hicks WH, Pernik MN, Adeyemo E, Mathews J, Pildain AJ, Payne R. Contiguous Meningioma and B-Cell Lymphoma: A Scoping Review and Case Illustration. World Neurosurg 2021; 158:132-138. [PMID: 34798339 DOI: 10.1016/j.wneu.2021.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The diagnosis of a contiguous, synchronous meningioma and central nervous system B-cell lymphoma is rare and associated with paradoxical treatment paradigms. We performed a scoping review of contiguous meningioma and B-cell lymphoma and included an additional illustrative case. METHODS The OVID Medline and PubMed databases were systematically searched using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. Only human clinical reports of contiguous, synchronous meningioma and B-cell lymphoma were included. We concurrently detailed a representative case from our institution. RESULTS Nine case reports met our criteria, including the present case. The average age at diagnosis was 67.4 years. Patients showed a female-to-male predominance of 7:2. The diagnosis of synchronous intracranial tumors was not suspected or discovered until after surgical resection in 100% of cases. All meningiomas were grade I on histopathologic diagnosis, while lymphomas were distributed between diffuse large B-cell lymphoma (56%), metastatic lymphoma (22%), Burkitt lymphoma (11%), and follicular lymphoma (11%). All patients underwent surgical resection. Patients (n = 5) treated with adjuvant chemotherapy had evidence of longer progression-free survival (median 12 months; range, 3-18 months) than patients without adjuvant chemotherapy (n = 2; median 2 months; range, 1-3 months). CONCLUSIONS Contiguous, synchronous meningioma/B-cell lymphoma is a rare diagnosis that may appear as an inconspicuous solitary intracranial neoplasm on imaging. Based on the limited cases and current treatment of lymphoma, progression-free survival may be contingent on the prompt initiation of chemotherapy targeting the lymphoma rather than surgical resection of the meningeal mass. Providers should prioritize prompt medical management.
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Affiliation(s)
- William H Hicks
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mark N Pernik
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Emmanuel Adeyemo
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John Mathews
- Texas Oncology, Medical City Dallas, Dallas, Texas, USA
| | - Alex J Pildain
- Department of Pathology, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Russell Payne
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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Primary CNS Burkitt Lymphoma: A Case Report of a 55-Year-Old Cerebral Palsy Patient. Case Rep Oncol Med 2018; 2018:5869135. [PMID: 30034894 PMCID: PMC6035833 DOI: 10.1155/2018/5869135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/16/2018] [Accepted: 05/29/2018] [Indexed: 01/08/2023] Open
Abstract
With primary central nervous system lymphoma (PCNSL) being a rare disease, the subtype of Burkitt lymphoma (BL) presenting as a sole CNS lesion is an even more exceptional diagnosis. A case of coexistent primary CNS Burkitt lymphoma (PCNSBL) with cerebral palsy (CP) is presented. A 55-year-old Caucasian male presented with increasing bilateral lower extremity weakness above his baseline in addition to signs of increased intracranial pressure. Four abnormal enhancing masses were detected on MRI with biopsy results consistent with Burkitt lymphoma. Complete staging workup was completed with no evidence of extra-CNS disease noted on PET/CT, bone marrow biopsy, or cerebral spinal fluid analysis. The patient was treated with intravenous as well as intrathecal chemotherapy and found to be in a complete remission at six months. Recurrence in the CNS was observed four months later with treatment consisting of whole brain radiation as well as intrathecal chemotherapy. Thirty months after diagnosis, the patient remains disease-free. To our knowledge, this is the first case of PCNSBL in the setting of CP. A review of literature regarding treatment options in this controversial setting is provided.
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Flow-Related Aneurysm within Glioblastoma: A Case Report and Review of Literature. World Neurosurg 2016; 89:729.e1-6. [DOI: 10.1016/j.wneu.2016.01.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 11/23/2022]
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To CY, Rajah G, Klein E, McNaughton M, Ham S, Haridas A, Kupsky W, Marin H, Sood S. Desmoplastic infantile ganglioglioma with associated giant aneurysm—case report. Childs Nerv Syst 2015; 31:1413-8. [PMID: 25922053 DOI: 10.1007/s00381-015-2722-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 04/20/2015] [Indexed: 11/26/2022]
Abstract
Desmoplastic infantile ganglioglioma (DIG) and supratentorial giant cerebral aneurysm are each extremely rare entities in infants. Here, we present the case of an 8-day old boy who had both of these conditions concurrently. To our knowledge, there is no previous case reported of a patient with coexisting DIG and giant aneurysm.
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Affiliation(s)
- Chiu Yuen To
- Department of Neurosurgery, Detroit Medical Center, Wayne State University, Detroit, MI, USA,
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6
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Zhong Z, Sun Y, Lin D, Sun Q, Bian L. Surgical treatment of brain tumor coexisted with intracranial aneurysm—case series and review of the literature. Neurosurg Rev 2013; 36:645-56; discussion 656. [DOI: 10.1007/s10143-013-0477-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 02/06/2013] [Accepted: 03/17/2013] [Indexed: 12/27/2022]
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7
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Coexistence of cerebral aneurysm and meningioma—Pure accident? Clin Neurol Neurosurg 2009; 111:647-54. [DOI: 10.1016/j.clineuro.2009.05.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Revised: 05/28/2009] [Accepted: 05/29/2009] [Indexed: 12/11/2022]
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8
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SAITO A, SUGAWARA T, WATANABE R, AKAMATSU Y, MIKAWA S, SEKI H. Evolution of Vestibular Schwannoma After Removal of Epidermoid Cyst of the Same Location -Case Report-. Neurol Med Chir (Tokyo) 2009; 49:495-8. [DOI: 10.2176/nmc.49.495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Atsushi SAITO
- Department of Neurosurgery, Iwate Prefectural Central Hospital
| | | | - Ryu WATANABE
- Department of Neurosurgery, Iwate Prefectural Central Hospital
| | | | - Shigeki MIKAWA
- Department of Neurosurgery, Iwate Prefectural Central Hospital
| | - Hirofumi SEKI
- Department of Neurosurgery, Iwate Prefectural Central Hospital
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Anda T, Haraguchi W, Miyazato H, Tanaka S, Ishihara T, Aozasa K, Nakamichi I. Ruptured distal middle cerebral artery aneurysm filled with tumor cells in a patient with intravascular large B-cell lymphoma. J Neurosurg 2008; 109:492-6. [DOI: 10.3171/jns/2008/109/9/0492] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors describe a very rare case of intravascular large B-cell lymphoma in a woman whose ruptured distal middle cerebral artery (MCA) aneurysms were filled with lymphoma cells. A 69-year-old woman who had undergone artificial graft replacement for an aortic aneurysm presented with transient left hemiparesis. Magnetic resonance imaging demonstrated a small fresh cerebral infarction in the right frontal lobe, although major cervical and cerebral arteries were shown to be intact on MR angiography. Antiplatelet and anticoagulation treatments commenced. On the 21st day after onset, the patient suffered a subarachnoid hemorrhage, and a digital subtraction angiogram revealed aneurysmal lesions in the distal MCA. Based on the histological examination of the resected aneurysms, proliferation of large B-cell lymphoma was identified in the dilated arterial lumen. On the 71st day after ischemic onset, intracranial hemorrhage recurred, and she died. Postmortem examination revealed similar lymphoma cells only in the intimal layer that had grown on the artificial graft, and it was decided that the patient had had intravascular large B-cell lymphoma. The preceding cerebral infarction was thought to be due to occlusion of the distal MCA by tumor embolus, which may be the initial pathological stage in aneurysm formation. For patients with incomprehensible ischemic cerebral stroke, neoplasm must be taken in consideration.
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Affiliation(s)
| | | | - Hajime Miyazato
- 2Internal Medicine, Syunan Memorial Hospital, Kudamatsu, Yamaguchi
| | - Shinsuke Tanaka
- 3First Department of Pathology, Yamaguchi University School of Medicine, Ube, Yamaguchi; and
| | - Tokuhiro Ishihara
- 3First Department of Pathology, Yamaguchi University School of Medicine, Ube, Yamaguchi; and
| | - Katsuyuki Aozasa
- 4Department of Pathology (C3), Osaka University Medical School, Suita, Osaka, Japan
| | - Itsuko Nakamichi
- 4Department of Pathology (C3), Osaka University Medical School, Suita, Osaka, Japan
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Masuoka J, Sakata S, Maeda K, Sugita Y. Adjacent epidermoid cyst and primary central nervous system lymphoma: case report. ACTA ACUST UNITED AC 2008; 69:530-3; discussion 533-4. [PMID: 18262247 DOI: 10.1016/j.surneu.2007.02.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 02/19/2007] [Indexed: 11/15/2022]
Abstract
BACKGROUND Except for cases with radiotherapy or phacomatosis, multiple primary brain tumors of different histologic types are rare. The authors report the association of an epidermoid cyst and a primary CNS lymphoma. CASE DESCRIPTION A 66-year-old man with a 20-year history of gait disturbance was admitted because of recently worsening symptoms. Magnetic resonance imaging showed an abnormal mass in the posterior fossa. The mass lesion had the appearance of a cystic tumor with a large mural nodule. Gross total removal of the tumor was performed. Histologic examination disclosed the cystic portion to be an epidermoid, whereas the nodular portion exhibited the histologic and immunohistochemical features of a malignant lymphoma. The lymphoma cells were shown to harbor EBV by in situ hybridization. CONCLUSIONS To our knowledge, this is the first report of the coexistence of an epidermoid cyst and primary CNS lymphoma. When the lesions are adjacent, a definite preoperative diagnosis can be difficult. Epstein-Barr virus-associated CNS lymphoma is rare among the immunologically normal population. The possible pathogenesis for the coexistence of these 2 tumors is discussed.
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Affiliation(s)
- Jun Masuoka
- Department of Neurosurgery, Saga University faculty of Medicine, Saga 840-8501, Japan.
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Buccoliero AM, Taddei GL, Caldarella A, Mennonna P, Ammannati F, Taddei A, Mariotti F. Meningioma-primary brain lymphoma association. Neuropathology 2004; 24:336-40. [PMID: 15641595 DOI: 10.1111/j.1440-1789.2004.00570.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The authors report a rare meningioma-primary cerebral B cell lymphoma association that occurred in an insulin-dependent type-I diabetic woman. The woman was initially operated on because of meningothelial meningioma of the fronto-basal region, and 2 months later showed a primitive-non-Hodgkin B cell lymphoma, localized in the same area as the meningioma. The published literature on the meningioma-primary cerebral lymphoma association is revised.
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Affiliation(s)
- Anna Maria Buccoliero
- Department of Human Pathology and Oncology, Medical School, University of Florence, Florence, Italy.
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Monabati A, Rakei SM, Kumar P, Taghipoor M, Rahimi A. Primary burkitt lymphoma of the brain in an immunocompetent patient. Case report. J Neurosurg 2002; 96:1127-9. [PMID: 12066916 DOI: 10.3171/jns.2002.96.6.1127] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary central nervous system (CNS) lymphoma is rare and is most often seen in immunodeficient patients. The majority of these tumors are the non-Hodgkin type and are high grade. Primary Burkitt lymphoma of the CNS in immunocompetent individuals has rarely been reported. The authors treated a 49-year-old woman who presented with left-sided weakness that had lasted 1.5 months. Magnetic resonance imaging revealed an oval mass in the left parietal region. with central necrosis and peripheral edema, and no attachment to the leptomeninges or ependyma. Pathological examination yielded a diagnosis of typical Burkitt lymphoma. Six months postoperatively, the patient is ambulatory and has improving neurological signs. This is a typical case of primary Burkitt lymphoma of the brain in an immunocompetent patient, which is a very rare event. The imaging pattern of the lesion is not typical of brain lymphomas and can result in an incorrect preoperative diagnosis of other brain tumors, such as glioblastoma multiforme. The patient's treatment and follow-up review are discussed.
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Affiliation(s)
- Ahmad Monabati
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Iran.
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Roitberg BZ, Cochran EJ, Thornton J, Charbel FT. Giant anterior communicating artery aneurysm infiltrated with a primary cerebral lymphoma: case report. Neurosurgery 2000; 47:458-62. [PMID: 10942022 DOI: 10.1097/00006123-200008000-00040] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE Central nervous system lymphomas exhibit angiotropic characteristics. Nevertheless, direct association with an intracranial aneurysm is very rarely reported. We present a case of a giant aneurysm infiltrated with a large cell non-Hodgkin's lymphoma. The incidence of primary central nervous system lymphoma is increasing, and similar cases may become more frequent in the future. CLINICAL PRESENTATION A 65-year-old man had presented with a giant anterior cerebral artery aneurysm, new onset of seizures, aphasia, and hemiparesis. The aneurysm was treated with Guglielmi detachable coils. Six months later, the patient exhibited fever and neurological deterioration. Magnetic resonance images suggested an enhancing lesion posterior to the neck of the aneurysm. Antibiotic treatment given elsewhere was unsuccessful. INTERVENTION A craniotomy for a suspected abscess was performed, with removal of the aneurysm and clipping of the neck. The aneurysm sac appeared to be filled with thrombus and pus. The results of aerobic, anaerobic, and fungal cultures were negative. Postoperative magnetic resonance images demonstrated a residual mass, posterior to the aneurysm within the striatum and the internal capsule. Histological examination of the aneurysm wall revealed a large B-cell lymphoma. The diagnosis was confirmed by a stereotactic biopsy. Radiation therapy resulted in a transient decrease in the size of the lesion. CONCLUSION Although the tumor was not apparent on the initial imaging studies, it may have been the cause of the patient's presenting symptoms. Infiltration of the aneurysm wall by the lymphoma also raises the possibility of a causal relationship. As the incidence of primary central nervous system lymphoma is reported to be on the increase, awareness this uncommon association of an aneurysm and malignant lymphoma is of value.
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Affiliation(s)
- B Z Roitberg
- Department of Neurosurgery, University of Illinois at Chicago, USA
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14
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Ogino M, Nakatsukasa M, Nakagawa T, Murase I. Ruptured anterior communicating artery aneurysm encased in a tuberculum sellae meningioma. Case report. J Neurosurg 1999; 91:871-4. [PMID: 10541248 DOI: 10.3171/jns.1999.91.5.0871] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This 70-year-old woman suffered a subarachnoid hemorrhage (SAH) from a ruptured anterior communicating artery aneurysm encased in a meningioma in the tuberculum sellae. Although preoperative magnetic resonance imaging disclosed that the aneurysmal complex was completely enclosed in the tumor, angiographic studies did not reveal arterial narrowing. The embedded aneurysm caused diffuse SAH rather than intratumoral hemorrhage. These factors indicated very little adhesion between the tumor and the encased arteries. Surgery was performed on the 20th day post-SAH. Intraoperative findings revealed that the tumor did not adhere to the enclosed vasculature except at the point of rupture of the aneurysm. The authors were able to clip the aneurysm safely after piecemeal removal of the tumor, which was finally extirpated without fear of aneurysm rupture. Careful stepwise procedures were essential to treat the aneurysm and the tumor simultaneously.
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Affiliation(s)
- M Ogino
- Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
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