[Tumors of the neuraxis and neuraxial sheaths during pregnancy (excluding tumors of the sellar region)].
An association between central nervous system neoplasm and pregnancy is uncommon although its frequency is underestimated. The most commonly observed tumors are acoustic neuromas, meningiomas and gliomas. The interactions between these tumors and pregnancy is not well known : Pregnancy could affect tumor growth by : - activating tumor growth by stimulating receptors; - increasing the peritumoral edema; - favoring immunotolerance due to pregnancy. Steroid hormone receptors and their therapeutic significance are described here, focusing particularly in meningiomas. Central nervous system tumors do not effect the progress of pregnancy per se but do the therapeutic implications. The clinical aspects are the same as in non-pregnant women. MRI appears to be the most adapted imaging technique. Neurosurgical guidelines are also described, with emphasis on symptomatic therapeutics, especially for seizure. Attitudes concerning the nature of the tumor and time of pregnancy are then discussed. The obstetrical attitude should be therapeutic abortion or delivery, with cesarean if necessary. Prognosis is getting better for the child and mother alike, but still remains poor.
Lioret
E
E
Service de Neurochirurgie, CHU Bretonneau.
François
P
P
Hommet
C
C
D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy