Newly diagnosed primary intracranial neoplasms in pregnant women: a population-based assessment.

Haas, Joanna F.; Jänisch, W; Staneczek, W

doi:10.1136/jnnp.49.8.874

Cited by 97 publications

(41 citation statements)

References 7 publications

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“…In a 1986 population-based epidemiologic study of the German Democratic Republic, Haas et al 1 reported that the number of meningiomas, acoustic neuromas, and primary malignant intracranial neoplasms diagnosed during pregnancy was less than expected when compared with the general population. With the use of tumor registry data from 1961 to 1979, these investigators identified 17 malignant brain tumors and 3 meningiomas among pregnant women.…”

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confidence: 99%

Obstetric emergencies precipitated by malignant brain tumors

Tewari

Cappuccini²,

Asrat³

et al. 2000

American Journal of Obstetrics and Gynecology

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OBJECTIVE:Our goal was to present a case series of pregnancy-associated malignant brain tumors. STUDY DESIGN: A review was conducted from 1978-1998 at 5 hospitals. RESULTS: Ten women were diagnosed with a malignant brain tumor during pregnancy (n = 8) or post partum (n = 2). Patients diagnosed antenatally exhibited severe symptoms, manifest between 27 and 32 weeks' gestation. Six were emergently delivered of their infants because of maternal deterioration, and 2 were delivered electively in the early third trimester after documentation of fetal pulmonary maturity. There were 4 maternal deaths and 1 neonatal death; all of the other infants maintained viability. CONCLUSIONS: Malignant brain tumors rarely occur in pregnancy. In contrast to reports that describe an indolent course, each of the 8 antenatal patients experienced a neurologic crisis. If symptoms are amenable to pharmacologic control, we advocate delivery in the early third trimester after documentation of fetal pulmonary maturity. To minimize temporal lobe or cerebellar herniation in neurologically unstable patients, a consideration should be made for cesarean delivery with the patient under general anesthesia, followed by immediate neurosurgical decompression. (Am J Obstet Gynecol 2000;182:1215-21.)

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confidence: 99%

Obstetric emergencies precipitated by malignant brain tumors

Tewari

Cappuccini²,

Asrat³

et al. 2000

American Journal of Obstetrics and Gynecology

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“…2 An epidemiological analysis performed in Germany of all tumours notified through the German Democratic Reporting System 1961-1975 suggested a frequency of 3.6 per 10 6 births which is slightly lower than the background frequency. Of the 29 tumours reported, astrocytoma (9 cases) and glioblastomas (6 cases) were the more frequently observed tumours.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 29 tumours reported, astrocytoma (9 cases) and glioblastomas (6 cases) were the more frequently observed tumours. 2 Haemangioblastomas comprise 1-2% of all intracranial tumours 3 and 7-12% of posterior fossa neoplasms. 3 They often occur sporadically; however, 20-40% of cases occur in association with von Hippell-Lindau disease (VHL).…”

Section: Discussionmentioning

confidence: 99%

Cerebellar haemangioblastoma presenting with dizziness in pregnancy: case report and review of the literature

et al. 2009

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Summary: Cerebral neoplasms are uncommon in pregnancy but should be considered in any pregnant woman with new onset neurological symptoms and signs. We report a case of cerebellar haemangioblastoma presenting in pregnancy and discuss the clinical presentation, diagnosis, surgical management and medical literature surrounding the condition.Keywords: pregnancy, maternal medicine, cerebellar haemangioblastoma, brain tumour, outcome CASEA 33-year-old Angolan woman presented to the antenatal day assessment unit (ADAU) at 28 weeks complaining of dizziness. She worked as a cleaner, was married, a Jehovah's Witness and a French speaker, with limited English vocabulary having arrived in the UK six years previously. Her body mass index was 26 and she had no past medical history of note. This was her fourth pregnancy having had a prior first trimester miscarriage and two uncomplicated spontaneous vaginal deliveries, the last of which was three years previously.On arrival on the ADAU she reported a 1-2-week history of right-sided headache and neck pain in association with vomiting. Temperature, pulse blood pressure and physical examination were all unremarkable and thyroid function tests were within normal limits. The patient was discharged with a diagnosis of dehydration secondary to vomiting as a result of a presumed urinary tract infection. She re-presented to the ADAU one week later with persistent vomiting, dizziness and epigastric pain when a diagnosis of viral labyrinthitis was presumed. Again temperature, pulse blood pressure and physical examination were unremarkable. However, she was admitted for intravenous rehydration. The following day her symptoms persisted. Closer questioning revealed the dizziness had been present for four weeks with vomiting for two weeks and the headache of gradual onset over the preceding three weeks. There was no history to suggest middle ear disease and she was not on ototoxic medications.On examination of the central nervous system the visual acuity was noted to be grossly intact, and fundoscopy normal. Pupils were symmetrical, reactive and accommodating. She had impairment of lateral gaze on both sides consistent with bilateral lateral rectus (or VI) palsies. There was no facial weakness or sensory loss and no bulbar signs. Peripheral nervous system examination of the upper and lower limbs was normal and she had down-going plantars. Sensation was normal. Cerebellar examination revealed moderate dysdiadochokinesis of the left hand with mild past pointing. There was marked truncal ataxia, with an unsteady broad based gait. In view of the neurological signs a magnetic resonance imaging (MRI) scan was arranged.The MRI scan showed a cystic lesion with a peripheral nodule within the cerebellum with no evidence of bleeding, the features being consistent with a haemangioblastoma (Figure 1). Gadolinium was not administered because of the pregnancy. Transfer to an obstetric unit with neurosurgical services on site was arranged. Steroids were given to promote fetal lung maturity in the event of ...

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“…The incidence of malignant brain tumors in pregnancy is 3.6 per million live births (15), and its management is often quite difficult. The treatment of glioma during pregnancy is complex as it may be associated with adverse effects on the fetus.…”

Section: Discussionmentioning

confidence: 99%

A case of pilocytic astrocytoma requiring tumor resection during pregnancy

Umehara

Okita

Nonaka

et al. 2016

Molecular and Clinical Oncology

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Abstract. Low-grade glioma (LGG) is often encountered in relatively young individuals, including women of childbearing age. Notably, case series describing pregnant women with LGG have been reported in the literature. The present study reported a case of pilocytic astrocytoma (PA) requiring tumor resection during pregnancy. The patient had a history of γ-knife radiotherapy for a brainstem tumor 17 years previously. The histological diagnosis was unclear. The tumor had remained stable following radiosurgery for 17 years, including during her first pregnancy. However, rapid tumor growth around the fourth ventricle occurred at week 25 of her second pregnancy. Therefore, an urgent tumor resection was performed despite the pregnancy. Partial resection was performed since the tumor had infiltrated the brainstem. The histological diagnosis was PA. The residual tumor volume decreased gradually following the delivery. Immunostaining of the tumor for the expression of progesterone receptor revealed focal staining. It is possible that reproductive factors, including specific hormonal changes during pregnancy, affected the tumor growth. The present study described this rare case of PA, which exhibited rapid growth and required urgent surgery during pregnancy. IntroductionLow-grade glioma (LGG) is often encountered in relatively young individuals, including women of childbearing age. Advances in the therapeutic management of LGG during the last decade and improvements in its prognosis are expected to assist young women with LGG in becoming pregnant. A number of case series are found in the literature describing pregnant women with LGG, either detected prior to pregnancy or newly diagnosed during pregnancy (1-10). In either case, its management is a particularly challenging situation since i) anti-tumor therapy is required, although the impact on the fetus or the pregnancy would require consideration or ii) the pregnancy would have to be discontinued, depending on the severity of the disease and the gestational age (10). Once a pregnancy with LGG is identified, patients, families, and neurosurgeons must recognize that they will encounter numerous difficult decisions at each stage of the pregnancy.The association between the behavior of the glioma and the pregnancy remains to be elucidated. Several previous studies have reported that the velocity of the diametric expansion of LGG increases during pregnancy (8) and that this acceleration may depend on multiple factors, including hormonal factors (11), growth factors (12), and hemodynamic changes (1,13), associated with pregnancy.Pilocytic astrocytoma (PA) is typically a slow-growing astrocytoma and is therefore, considered the 'most benign' of all the astrocytomas. It occurs predominantly in childhood and adolescence (14). Growth of PA during pregnancy is rarely reported. The present study reported a case in which PA growth occurred and urgent resection was required during pregnancy. The behavior of the glioma is focussed on during the pregnancy. Case reportA 30-year-old pregna...

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Newly diagnosed primary intracranial neoplasms in pregnant women: a population-based assessment.

Cited by 97 publications

References 7 publications

Obstetric emergencies precipitated by malignant brain tumors

Obstetric emergencies precipitated by malignant brain tumors

Cerebellar haemangioblastoma presenting with dizziness in pregnancy: case report and review of the literature

A case of pilocytic astrocytoma requiring tumor resection during pregnancy

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