title: 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.
authors.affiliation: Department of Neurosurgery, Servidores do Estado Hospital, Rio de Janeiro, Brazil. jclynch@globo.com
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Lynch
authors.forename: Fabiano
authors.initials: F
authors.lastname: Gouvêa
authors.forename: João Cláudio
authors.initials: JC
authors.lastname: Emmerich
authors.forename: Georges
authors.initials: G
authors.lastname: Kokinovrachos
authors.forename: Celestino
authors.initials: C
authors.lastname: Pereira
authors.forename: Leonardo
authors.initials: L
authors.lastname: Welling
authors.forename: Sara
authors.initials: S
authors.lastname: Kislanov
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002585:Cesarean Section; D003399:Craniotomy / Q000379:methods; D036861:Delivery, Obstetric; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome