Management strategy for brain tumour diagnosed during pregnancy

Abstract

The occurrence of brain tumours during pregnancy is unusual, when this happen jeopardises the lives of both the mother and infant. This article aims at identifying the best medical management to be followed for a pregnant patient harbouring a brain tumour. The records of 10 patients with brain tumours diagnosed during pregnancy were retrospectively examined. The histological diagnosis revealed 3 grade 2 astrocytomas, and 1 grade 2 oligodendroglioma. All this gliomas (100%) developed dedifferentiation in the mean period of 27 months. The histology of the others tumours were 2 grade 1 meningiomas, 1 melanoma metastasis, 1 epidermoid tumour, 1 case of chemodectoma and 1 patient with a pituitary apoplexy in a non-function adenoma. There was no operative mortality in these series, and no fetal deaths were observed. Prior to craniotomy, five patients had caesarean sections, two others had vaginal deliveries. In three patients the delivery took place after the brain tumour treatment. Two patients had vaginal delivery and eight caesarean sections. The best moment to recommend the craniotomy and the neurosurgical removal of the tumour will depend of the mother's neurological condition, the tumour histological type as well as the gestational age. A multi-disciplinary approach was used to determine the optimal management for each patient.

Impact of maternal brain tumours on perinatal and maternal management and outcome: a single referral centre retrospective study

“…Short-term maternal mortality was high in our series (19%), but similar to those reported by Isla et al [9] and Lynch et al [10]. The size of our series precludes analysing the impact of tumour type on outcome, but mortality rates of up to 50% have been reported in malignant brain tumours associated with pregnancy [1,11].…”

Two Pregnants' Cesarean Anesthetic Management Who Have Intracranial Mass Lesion: Case Report

“…11 Bazılarında ise bizim olgularımızda olduğu gibi önce sezaryen, daha sonra nörolojik operasyonlar yapılmıştır. 12 Literatür incelendiğinde, gebelik ve eş zamanlı intrakraniyal yer kaplayıcı lezyonun beraber olduğu nadir vakalarda cerrahi tedavi planlanıyorsa intrakraniyal patoloji ile eş zamanlı ya da ayrı vakitlerde sezaryen ameliyatı yapılmasının birbirine üstünlüğü gösterilmemiştir. Eğer aynı anda cerrahi operasyon planlanıyorsa, önce sezaryen ameliyatı-nın yapılmasının fetüsün uzamış genel anestezinin etkilerinden daha az etkilenmesi için tercih edildiği belirtilmiştir.…”

A case of pilocytic astrocytoma requiring tumor resection during pregnancy

“…If fetal pulmonary maturity has been attained, delivery prior to neurosurgery is preferable (16). Prompt therapy in parallel with the pregnancy appears to be more actively required in patients with high-grade glioma (HGG) or newly diagnosed symptomatic LGG during pregnancy compared with in patients with known LGG (kLGG) prior to pregnancy (2)(3)(4)(5)(6)9).…”

“…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)(2)(3)(4)(5)(6)(7)(8)(9)(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).…”