The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review

Neoplastic etiology of intracranial cerebral aneurysm is rare. Yet, the risk of its development is higher in malignant tumor patients receiving radiation therapy. Due to the possible negative effects of irradiation on intracranial vessel walls, the risk of aneurysm formation after radiation therapy...

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Main Authors: Krešimir Rotim, Bruno Splavski, Zlatko Trkanjec, Vladimir Kalousek, Ante Rotim, Tomislav Sajko
Format: Article
Language:English
Published: Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 2020-01-01
Series:Acta Clinica Croatica
Subjects:
Online Access:https://hrcak.srce.hr/file/354171
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author Krešimir Rotim
Bruno Splavski
Zlatko Trkanjec
Vladimir Kalousek
Ante Rotim
Tomislav Sajko
author_facet Krešimir Rotim
Bruno Splavski
Zlatko Trkanjec
Vladimir Kalousek
Ante Rotim
Tomislav Sajko
author_sort Krešimir Rotim
collection DOAJ
description Neoplastic etiology of intracranial cerebral aneurysm is rare. Yet, the risk of its development is higher in malignant tumor patients receiving radiation therapy. Due to the possible negative effects of irradiation on intracranial vessel walls, the risk of aneurysm formation after radiation therapy, which is crucial for some types of breast cancer patients, continues to be a matter of debate. The aim of this study was to evaluate the hazard of multiple intracranial aneurysm development in patients with malignant disease undergoing radiation therapy. It is based on literature review and case report of a 77-year-old female patient who underwent surgery for multifocal invasive hormone-receptor positive ductal breast carcinoma of no special type, followed by chemotherapy, adjuvant radiation and hormone therapy. Her comorbidity included arterial hypertension and type 2 diabetes. Six unruptured intracranial aneurysms of different bilateral locations were diagnosed incidentally by multi-slice computed tomography angiography and digital subtraction angiography of cerebral vessels. Due to the bilateral aneurysm multiplicity, tumor characteristics and prognosis, comorbidity and relatively advanced age, the patient was not selected for active endovascular or microsurgical aneurysm treatment but only periodical clinical, oncologic and radiological follow-up was advised. In conclusion, the risk of multiple intracranial aneurysm formation in patients with breast cancer undergoing radiation therapy is low, but still possible. Long-term follow-up and regular cerebral angiographic check-up studies are necessary in selected malignant patients to decrease such a risk and to evade the worst outcome associated with aneurysm rupture.
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spelling doaj.art-2b01d5401af047bfaadc77dd042134702024-04-15T16:05:32ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512020-01-0159.2.35936410.20471/acc.2020.59.02.21The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature ReviewKrešimir Rotim0Bruno Splavski1Zlatko Trkanjec2Vladimir Kalousek3Ante Rotim4Tomislav Sajko5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, CroatiaDepartment of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, CroatiaDepartment of Neurology, Sestre milosrdnice University Hospital Centre, Zagreb, CroatiaDepartment of Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, CroatiaDepartment of Neurosurgery, Dubrava University Hospital, Zagreb, CroatiaDepartment of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; University of Applied Health Sciences, Zagreb, CroatiaNeoplastic etiology of intracranial cerebral aneurysm is rare. Yet, the risk of its development is higher in malignant tumor patients receiving radiation therapy. Due to the possible negative effects of irradiation on intracranial vessel walls, the risk of aneurysm formation after radiation therapy, which is crucial for some types of breast cancer patients, continues to be a matter of debate. The aim of this study was to evaluate the hazard of multiple intracranial aneurysm development in patients with malignant disease undergoing radiation therapy. It is based on literature review and case report of a 77-year-old female patient who underwent surgery for multifocal invasive hormone-receptor positive ductal breast carcinoma of no special type, followed by chemotherapy, adjuvant radiation and hormone therapy. Her comorbidity included arterial hypertension and type 2 diabetes. Six unruptured intracranial aneurysms of different bilateral locations were diagnosed incidentally by multi-slice computed tomography angiography and digital subtraction angiography of cerebral vessels. Due to the bilateral aneurysm multiplicity, tumor characteristics and prognosis, comorbidity and relatively advanced age, the patient was not selected for active endovascular or microsurgical aneurysm treatment but only periodical clinical, oncologic and radiological follow-up was advised. In conclusion, the risk of multiple intracranial aneurysm formation in patients with breast cancer undergoing radiation therapy is low, but still possible. Long-term follow-up and regular cerebral angiographic check-up studies are necessary in selected malignant patients to decrease such a risk and to evade the worst outcome associated with aneurysm rupture.https://hrcak.srce.hr/file/354171Aneurysms, intracranial, multipleBreast cancerRadiation therapy
spellingShingle Krešimir Rotim
Bruno Splavski
Zlatko Trkanjec
Vladimir Kalousek
Ante Rotim
Tomislav Sajko
The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review
Acta Clinica Croatica
Aneurysms, intracranial, multiple
Breast cancer
Radiation therapy
title The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review
title_full The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review
title_fullStr The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review
title_full_unstemmed The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review
title_short The Risk of Multiple Intracranial Aneurysm Formation in Patients with Malignant Disease Undergoing Radiation Therapy: a Case Report and Literature Review
title_sort risk of multiple intracranial aneurysm formation in patients with malignant disease undergoing radiation therapy a case report and literature review
topic Aneurysms, intracranial, multiple
Breast cancer
Radiation therapy
url https://hrcak.srce.hr/file/354171
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