Abstract
Primary brain tumors associated with intracranial aneurysm are rare. A combination
of glioblastoma multiforme (GBM) with cerebral aneurysm is even more rare. We present
a 67-year-old female, who suffered from progressive weakness of the right limbs and
dysphasia for 2 days. She was referred from another hospital with impression of having
a brain tumor. The non-enhanced computed tomographic (CT) scan of the brain showed
a mass lesion over the left parietal region, and another tiny lesion with relatively
high density over the left suprasellar region. After admission, the carotid angiogram
revealed a 13 × 12 × 14 mm aneurysm with a base about 8 mm from the anterior wall
of the left supraclinoid internal carotid artery (ICA) between the left ophthalmic
artery and the left anterior choroid artery. We first clipped the aneurysm by a basal
pterion keyhole approach. One week later, the tumor was en bloc removed by a small
left parietal craniotomy under the guidance of a navigator. The final diagnosis was
confirmed by histopathological examination as GBM. After the surgeries, the patient
received palliative radiotherapy with a dose of 4000 cGy. She recovered well with
no evidence of recurrence of the tumor one year after the operations. In this report,
the careful diagnosis and the possible mechanisms of concurring GBM and cerebral aneurysm,
as well as the strategies of surgical treatment involving minimally invasive approaches
are discussed.
Key words
Aneurysm - glioblastoma multiforme (GBM) - keyhole - navigator
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Chiung-Chyi Shen, M. D., Assistant Professor
Department of Neurosurgery · Taichung Veterans General Hospital
160, Sec. 3, Taichung-Kang Road
Taichung, Taiwan, R.O.C. ·
Telefon: +886-4-23741218
Fax: +886-4-23741218
eMail: ccshen@vghtc.vghtc.gov.tw
