Subarachnoid hemorrhage caused by a neoplastic aneurysmfrom a urotherial carcinoma

An 86 year-old man was admitted to our hospital with sudden left paralysis. He had received no medical treatment though the ureteral carcinoma was pointed out as in the past. CT scan demonstrated subcortical hemorrhage in the right frontal lobe. MRI demonstrated no vascular abnormality. He was treated conservatively and moved to rehabilitation ward. He complained of a sudden headache on the 31st day of hospitalization. Subarachnoid hemorrhage was found in the left convexity area by CT scan and a de novo fusiform aneurysm was discovered at the peripheral branch of middle cerebral artery by MRA and angiography. Vascular trapping and resection of aneurysm was performed immediately. Postoperative, the pathological diagnosis was a neoplastic aneurysm. Atypical cells had invaded the aneurismal wall. After the operation, any cerebral infarction according to the vascular trapping did not develop. In the treatment of the patient with carcinoma, it is necessary to note that the formation and the rupture of a cerebral aneurysm will be caused in a short term.