The coexistence of oligo-astrocytoma, arteriovenous malformation and aneurysm: a rare case

This report is of a rare case of mixed oligo-astrocytoma and arteriovenous malformation (AVM) associated with an aneurysm in a 50-year-old man, who presented with a progressive history of headache and vomiting due to acute intracranial hemorrhage. Initial images were suggestive of a right frontal AVM and an aneurysm on the left anterior cerebral artery (ACA) for which a right frontotemporal craniotomy was performed. Intraoperatively, a gross total resection of the AVM was achieved and then the aneurysm was clipped. After surgery, histopathological examination demonstrated oligo-astrocytoma in the resected lesion of AVM. The clinical, radiological, and operative data were reviewed, so were the histological findings. To the authors’ knowledge, this is the first reported case with glioma, AVM and aneurysm. The association of tumors and vascular malformations should always be taken into consideration. We suggest that, in selected cases, preoperative angiography should be performed in patients with brain tumor, and that preoperative MRI scan and postoperative accurate histopathological evaluation are required to exclude tumors in patients with AVM. So far, whether intermixed or closely related tumors and vascular malformations are combined or represent two entities remains unclear. Further studies of more such patients are needed to explain such an association.