Congenital glioblastoma coexisting with vascular developmental anomaly

Abstract

A b s t r a c t Congenital central nervous tumours form a unique group of neoplasms. They are different from other tumour groups

Congenital Brain Tumor within the First 2 Months of Life

“…Germinal tumors are observed between 22 weeks and 32 weeks, and gliomas such as astrocytomas and glioblastomas are detected after 32 weeks. 22,23 On average, the gestational age at diagnosis is 27 weeks for teratomas, 21 weeks for hamartomas, and 34 weeks for gliomas. 11 No information is available on the relevant gestational age for the other types of CBTs.…”

Congenital Glioblastoma Multiforme: An Unusual and Challenging Tumor

“…20 Fetal MRI might also provide useful information concerning tumor vascularity, hemorrhage, and assessment of intracranial anatomy (normal brain development and condition, hydrocephalus, midline shift, potential herniation) and for the detection of other congenital malformations. 2,9,29,35 Interestingly, ocular skew deviation found on fetal MRI has been described in one case and was considered a poor prognostic indicator linked with impending transtentorial herniation. 20…”

“…In cases where follow-up imaging is available, significant change in the size of the intracranial mass might be described, not only due to the tumor's reported tendency to increase rapidly, but sometimes due to the presence of hemorrhage as well (►Table 1). 2,4,9,29,35 It should be noted that there are no specific diagnostic criteria for congenital GBM. Other congenital brain tumors, as well as vascular malformations, infarctions, and primary hemorrhage should be included in the differential diagnosis since a definite diagnosis cannot be made only by prenatal sonography.…”

“…2,3 Most congenital GBMs are described as heterogeneous, typically solid masses, with varied signal intensity and with areas of hemorrhage and necrosis (►Table 2). 3,29,35,45 Necrosis with ringlike enhancement has been proposed as the major MRI criterion differentiating GBM from other intracranial tumors (especially anaplastic astrocytomas). It should be stressed though that the administration of contrast medium in fetal MRI is not recommended due to in utero retention and possible teratotoxicity.…”

“…The tumor is usually described as infiltrative, densely cellular, with high mitotic activity, increased MIB-1 rate, and with marked cytoplasmic and nuclear pleomorphism. 2,5,7,8,29,35 Despite the fact that it is considered highly invasive, exceptional cases without signs of infiltration have also been reported. 4,7,11 Areas of necrosis (zonal or pseudopalisading), as well as vascular proliferation and endothelial hyperplasia are typical findings.…”