• Shiying Gai, Nan Lv, Qi Zhang, Qiao Zuo, Jianmin Liu, and Qinghai Huang.
• Department of Neurosurgery, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China.
• World Neurosurg. 2020 Jan 1; 133: e376-e384.

ObjectiveWe present a case of multiple myxoma-related intracranial aneurysms and reviewed the recent relevant literature to investigate their natural course and develop a reasonable treatment algorithm.MethodsWe have reported a new case of multiple myxoma-related intracranial aneurysms and performed a search of current studies (2001 to the present) in PubMed. The keywords used were as follows (single words or combinations): neoplastic aneurysm, oncotic aneurysm, aneurysm, and myxoma. Only patients with multiple aneurysms resulting from cardiac myxoma and with adequate follow-up information pertinent to the analysis were included.ResultsA total of 41 patients, including our present patient, were studied. Of the 41 patients, 28 had received conservative treatment as the primary choice. Most lesions (n = 22) were stable during follow-up, except for 3 in which aneurysm evolution was observed. A total of 8 patients had undergone microsurgery, including aneurysm resection in 3, aneurysm clipping in 2, clipping followed by resection in 2, and aneurysm trapping in 1. Endovascular treatment was performed in 2 patients. Radiation therapy was used in 1 patient, and the parent artery proved to be occluded at the 1-year follow-up examination. A combination of chemotherapy and microsurgery was used in 1 patient. All the cases that had been managed aggressively were stable during further follow-up.ConclusionThe prognosis was good for most patients with multiple myxoma-related intracranial aneurysms, and most myxoma-related aneurysms were stable. Conservative treatment and routine follow-up are recommended for most patients. However, for patients with evolving or ruptured aneurysms, invasive treatment, including open surgery and endovascular treatment, should be considered.Copyright © 2019. Published by Elsevier Inc.

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