Fetal intracranial tumors: a review of 27 cases

Abstract

Fetal intracranial tumors are rare. The diagnosis is generally made on histology after birth. The aim of this study was to analyze clinical and imaging data in a series of fetal intracranial tumors and emphasize the findings that may help approach the diagnosis antenatally. We retrospectively analyzed imaging and clinical findings in 27 cases of fetal intracranial tumors assessed by ultrasound (27/27) and MR imaging (24/27). A histological diagnosis was always obtained. Main diagnoses included 15 germinal tumors (13 teratomas), 4 glial tumors, 2 craniopharyngiomas and 3 hamartomas. Average gestational age at diagnosis was 27 weeks for teratomas, 21 weeks for hamartomas and 34 weeks for glial tumors. All tumors but one were supra tentorial, and the lesion extended in the posterior fossa in two teratomas. A heterogeneous pattern, which was more frequently seen in teratomas, was better visualized by MR than US imaging. In addition, in two cases of teratomas, MR imaging better assessed the extension of the tumor. Teratomas and gliomas are the most frequent brain tumors in the fetus. US and MR imagings appear complementary in the prenatal assessment of these lesions.

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders

“…Of these, the majority are supratentorial masses [45][46][47]. Reviews show that they are generally diagnosed at a gestational age of 28 weeks (ranging from 18 to 36 weeks).…”

Infantile Intracranial Neoplasms: Characteristics and Surgical Outcomes of a Contemporary Series of 21 Cases in an Egyptian Referral Center

“…According to the worldwide survey of 886 infants reported by Di Rocco et al [36] and an extensive literature review of 1,289 infants by Larouche et al [37], the most common intracranial tumor during the first year of life was astrocytoma (30%), followed by medulloblastoma, ependymoma and CPP (about 10–12% each). However, the most common neonatal and fetal brain tumor was teratoma (30–35%), followed by astrocytoma (16–19%), CPP and medulloblastoma (about 7–13% each) [17,19,20,21,31,32,38]. …”

“…Recently, fetal MRI proved to be superior to US in tumor visualization and the assessment of tumor size. However, both techniques are complementary in the prenatal assessment of these lesions [38]. …”

Prenatal diagnosis of intracranial immature teratoma in the third trimester using 2D and 3D sonography

“…This tumor is usually located in the supratentorial region and is related to maternal anticoagulant therapy, abdominal trauma, or fetal coagulation disorders [13]. The prognosis of these tumors is poor, with survival rates lower than 10-28 %, and depends on gestational age and the size of the mass at the time of diagnosis [14].…”