Management of brain tumors presenting in pregnancy: a case series and systematic review

Rodrigues, Adrian; Waldrop, Anne R.; Suharwardy, Sanaa; Druzin, Maurice L.; Michael, Cassia; Ansari, Jessica; Stone, Sarah A; Jaffe, Richard A.; Jin, Michael C.; Li, Gordon; Gephart, Melanie Hayden

doi:10.1016/j.ajogmf.2020.100256

Cited by 16 publications

(29 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This may be related to the fact that meningiomas are known to express progesterone receptors, which lead to increased symptom severity during pregnancy [41]. The histological types of brain tumors are diverse [38], and in this study, we found a great variety of histological types not necessarily specific to pregnancy, which is in accordance with previous reports [37,42].…”

Section: Discussionsupporting

confidence: 91%

“…With respect to the mode of delivery, cesarean section was selected in most patients, which is consistent with previous reports [37]. Cesarean section is an option to avoid increased intracranial pressure due to vaginal delivery [39].…”

Section: Discussionsupporting

confidence: 58%

“…Because of the low frequency of the disease, there is no confirmed evidence on the diagnosis and treatment of such tumors. Although a systematic review of case series on brain tumors in pregnancy was recently reported, the review included cases reported more than 20 years ago, thus likely yielding differences in the management of pregnancy as well as the diagnosis and treatment of the brain tumors [37]. In this study, we focused on cases reported mainly in Japan after the year 2000 in an attempt to analyze patients with similar medical backgrounds.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: Maternal brain tumors diagnosed during pregnancy are very rare, and their clinical course remains incompletely understood. We recently experienced a case of a brain tumor diagnosed at 30 weeks of gestation, and the treatment was initiated after delivery at 32 weeks of gestation. In this study, we reviewed case reports of brain tumors diagnosed during pregnancy, focusing on whether the brain tumor was treated during pregnancy or after termination of pregnancy and on the timing of therapeutic intervention. Materials and Methods: We searched PubMed and Ichushi-Web for articles published after January 2000 that reported cases of maternal brain tumors diagnosed during pregnancy. The patients were divided into two groups according to whether the tumor was treated during pregnancy (Group A) or after termination of pregnancy (Group B). Results: In total, 42 patients were included in the study (13 (31%) in Group A and 29 (69%) in Group B). The most common symptoms before diagnosis were those caused by increased intracranial pressure (57.1%). The diagnosis was made at 18 ± 6 weeks of gestation in Group A and 26 ± 9 weeks of gestation in Group B (p = 0.007). In all cases diagnosed after 34 weeks of gestation, termination of pregnancy was followed by treatment. Treatment was initiated within two weeks of diagnosis in 50% of patients in Group A and 30% in Group B. Conclusions: When severe symptoms caused by increased intracranial pressure last for several weeks, imaging tests should be considered. Termination of pregnancy is a good option for a brain tumor diagnosed after 34 weeks of gestation, while comprehensive treatment decisions should be made based on the severity of symptoms and the course of pregnancy in other cases.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…And there are no extracranial tumors that are likely to metastasize that are uniquely related to the specific pregnancy (5). But certain factors such as immunological tolerance, hormone-mediated growth, and hemodynamic changes may promote neoplasm growth mediating a common pathway to increasing intracranial mass effect (3,4,6). Intracranial tumors usually initially present with symptoms and signs of increased intracranial pressure such as headache, dizziness, or vomiting, related focal neurological deficits and seizures, which are often confused with pregnancy itself, hypertensive disorders and thrombosis in pregnancy (7).…”

Section: Discussionmentioning

confidence: 99%

Case Report: A Pregnant Woman Diagnosed as ALK-Rearrangement Lung Large Cell Neuroendocrine Cancer With Brain Metastasis

Zhu

Wang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

Concomitant malignant tumors and pregnancy present many difficult questions to both clinicians and patients. Due to no specific guidelines, each aspect of clinical management requires special considerations. This current report presents a rare case of a 38-year-old pregnant woman at gestational age 33 weeks with complaints of weakness of her right limbs for 2 weeks. After successive cesarean section and craniotomy, a diagnosis of lung large cell neuroendocrine carcinoma (LCNEC) metastatic to the brain was eventually made. Next generation sequencing (NGS) showed ALK-EML4 gene fusion. Immediately afterwards she was started on the targeted therapy with the ALK inhibitor alectinib. Ten months later, all known lesions exhibited a rapid regression, and no new brain metastases were found. Consequently, the therapeutic effect was considered as a partial response. Then, we review the previous literature using PubMed on maternal malignant brain tumors diagnosed during pregnancy, or lung LCNEC associated with ALK fusion, or ALK inhibitors treatment among the pregnant women, eventually, and discuss the concerns of dealing with these patients.

show abstract

“…For patients with benign brain tumors, craniotomy can be performed after full-term production according to the situation. For patients with middle and late stage and large brain tumors, immediate craniotomy is recommended to reduce intracranial pressure [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence Algorithm-Based Analysis of Ultrasonic Imaging Features for Diagnosis of Pregnancy Complicated with Brain Tumor

Wei

Yang

et al. 2021

Journal of Healthcare Engineering

View full text Add to dashboard Cite

This research was to explore the accuracy of ultrasonic diagnosis based on artificial intelligence algorithm in the diagnosis of pregnancy complicated with brain tumors. In this study, 18 patients with pregnancy complicated with brain tumor confirmed by pathology were selected as the research object. Ultrasound contrast based on artificial bee colony algorithm was performed and diagnosed by experienced clinicians. Ultrasonic image will be reconstructed by artificial bee colony algorithm to improve its image display ability. The pathological diagnosis will be handed over to the physiological pathology laboratory of the hospital for diagnosis. The doctor’s ultrasonic diagnosis results were compared with the pathological diagnosis stage results of patients, and the results were analyzed by statistical analysis to evaluate its diagnostic value. The comparison results showed that the number and classification of benign tumors were the same, while in malignant tumors, the number diagnosis was the same, but there was one patient with diagnostic error in classification. One case of mixed glial neuron tumor was diagnosed as glial neuron tumor, and the diagnostic accuracy was 94.44% and the K value was 0.988. The diagnostic results of the two were in excellent agreement. The results show that, in the ultrasonic image diagnosis of patients with brain tumors during pregnancy based on artificial intelligence algorithm, most of them are benign and have obvious symptoms. Ultrasound has a good diagnostic accuracy and can be popularized in clinical diagnosis. The results can provide experimental data for the clinical application of ultrasonic image feature analysis based on artificial intelligence as the diagnosis of pregnancy complicated with brain tumors.

show abstract

Management of brain tumors presenting in pregnancy: a case series and systematic review

Cited by 16 publications

References 60 publications

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

Case Report: A Pregnant Woman Diagnosed as ALK-Rearrangement Lung Large Cell Neuroendocrine Cancer With Brain Metastasis

Artificial Intelligence Algorithm-Based Analysis of Ultrasonic Imaging Features for Diagnosis of Pregnancy Complicated with Brain Tumor

Contact Info

Product

Resources

About