Fetal Brain Tumors, a Challenge in Prenatal Diagnosis, Counselling, and Therapy

Abstract

Fetal brain tumors are a rare entity with an overall guarded prognosis. About 10% of congenital brain tumors are diagnosed during fetal life. They differ from the postnatally encountered pediatric brain tumors with respect to location and tumor type. Fetal brain tumors can be benign or malignant and infiltrate or displace adjacent brain structures. Due to their high mitotic rate, they can show rapid growth. Outcome depends on age of diagnosis, size, and histological tumor type. Findings like polyhydramnios and macrocephaly encountered on routine ultrasound are frequently associated. Detailed prenatal anomaly scan and subsequent fetal magnetic resonance imaging (MRI) may identify the brain tumor and its severity. Both maternal and fetal prognosis should be included in prenatal counselling and decision making.

Central nervous system tumours in neonates: what should the neonatologist know?

“…The first sign of a congenital tumour with prenatal onset is usually polyhydramnios, more commonly in the second and third trimester secondary to both hypothalamic dysfunction and high cardiac output [ 2 , 18 ].…”

“…Once a neoplasm is diagnosed in the prenatal or neonatal period, a multidisciplinary interview with both expectant parents must be organised in order to provide the most complete and exhaustive counselling possible, informing them of the treatment options and prognosis, as well as the potential risks for both mother and foetus [ 18 ].…”