[Association of an epidermoid tumor with a cerebral aneurysm on the contralateral internal carotid artery].
A 71-year-old female was evaluated for a sudden loss of consciousness. Initial computed tomography and cerebral angiography revealed a severe subarachnoid hemorrhage, a large cystic lesion in the left occipital region, and an aneurysm at the bifurcation of the internal carotid and the posterior communicating artery on the right side. As the subarachnoid hemorrhage was thought to be due to rupture of the aneurysm, we attempted to clip the aneurysmal neck at first, and 2 weeks later the cystic tumor was removed for the purpose of internal decompression. The extirpated specimen proved to be an epidermoid tumor. Association of a brain tumor and an cerebral aneurysm is very rare, especially a combination of an epidermoid tumor and a cerebral aneurysm, and until now only 2 cases have been reported to the best of our knowledge. Moreover, the epidermoid tumor of our case was located intracerebrally. The phenomenon that the internal carotid aneurysm was on the left side and the tumor on the right side may suggest that these 2 lesions originated quite coincidentally. It is controversial to decide which lesion and when to treat first in a case of association of a tumor and an aneurysm, and we discussed as to the surgical therapy reviewing literature.
Nishikawa
M
M
Department of Neurosurgery, Hamamatsu Rosai Hospital, Japan.
Handa
H
H
Nakahara
I
I
Yamakawa
H
H
Inagawa
S
S
Koide
T
T
D000368:Aged; D001927:Brain Diseases / Q000150:complications* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications*; D002343:Carotid Artery, Internal; D004814:Epidermal Cyst / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D013345:Subarachnoid Hemorrhage / Q000209:etiology