Fetal Brain Tumors: A Review of 154 Cases

Abstract

The purpose of this literature review is to describe the various types of brain tumors that occur in the fetus, their locations, initial findings, pathology, and outcome. Data are presented that show which patients are likely to survive or benefit from treatment compared with those who are unlikely to respond. An analysis is performed on patients with fetal brain tumors that were detected prenatally by imaging studies or discovered directly after birth. The review revealed 154 fetuses presenting with brain tumors. Teratoma was the leading neoplasm. Next was astrocytoma followed by craniopharyngioma, primitive neuroectodermal tumor, choroid plexus papilloma, meningeal tumors, and ependymoma. The most common presenting findings were macrocephaly and an intracranial mass. Overall hydrocephalus was next, followed by stillbirth. Most tumors were detected during the third trimester of pregnancy. Over a third of the affected fetuses were stillborn. Many tumors were inoperable as they occupied much of the intracranial cavity and involved large areas of the brain. Overall survival rate was 23/154, or 15%. Generally fetal brain tumors are associated with a poor prognosis.

Supratentorial Extraventricular Anaplastic Ependymoma Presented With Headache in Pregnancy: Case Report and Review of the Literature

“…Only one similar case was found in the literature. However, the tumor had occurred during the first trimester and located infratentorially in the fourth ventricle (Table 3) [43,44].…”

Ultrasound Images and Postnatal Clinical Outcomes in Primary and Secondary Abnormalities of Fetal Brain (Series of 53 Cases)

“…It is caused by difficulties of adequate prognosis of postnatal result, though exactly this prediction is the main task of prenatal consultation given to a pregnant woman with suspicion of abnormal development of the fetus central nervous system (CNS). Such anomalies of fetal CNS as agenesis of the corpus callosum and cortical displasia, found mainly in the second half of pregnancy, after 20-26 weeks [3]. The perinatal prognosis in some forms of antenatal fetal brain lesions is definitely unfavorable.…”

“…But the information about the child development prognosis with moderate development of prosencephalon disorder, as well as in isolated and associated callosal anomalies, some kinds of the posterior fossa anomalies, hydrocephalic syndrome is contradictory and indefinite [2]. Also, there are difficult issues for prediction results in focal tumor and cystic antenatal brain lesions [3]. Diagnostics of brain lesions at the antenatal stage with a target NSG research allows to find fetuses with the necessity of postnatal observation.…”

A case of vaginally terminated fetus who had intracranial immature teratoma after transabdominal fetal cephalocentesis

“…신생아의 두개내종양은 전체 소아 종양의 약 0.5-1.9%를 차지할 정 도로 매우 드물며 [1,2], 이 중 18%가 분만 전 또는 분만 시 진단된다 [3]. 자궁내에서 두개내출혈을 일으킬 수 있으며 임신 주수가 증가함에 따라 자궁내에서 그 크기가 증가하여 난산을 유발하는 경우가 많고, 조산이 나 사산이 되는 경우도 있다 [4].…”

“…종양에 의해서 태아 뇌의 정상조직이 파괴되고 대치되어 있는 경우도 많다. 태아의 두개내기형종은 태아의 두개내종양 중 가장 예후가 나쁜 것으 로 알려져 있으며 약 7.8%의 생존율을 가진다 [2]. 두개내기형종을 가진 태아는 자궁내 사망이 되거나 출생 직후 사망하는 경우가 대부분이다.…”