Advanced case of glioblastoma multiforme and pregnancy. An ethical dilemma.
Glioblastoma multiforme (GBM) is the most common and malignant form of the glial tumors. Advanced and treated GBM is rarely associated with pregnancy for many reasons. Glioblastoma multiforme presenting during pregnancy carries unique challenges to the patient, baby, family, and health care providers. We describe an unusual case of advanced GBM that was treated with maximum doses of chemotherapy and radiations, and she became pregnant and presented at eighteenth weeks of gestation. Her medical management was associated with a significant ethical dilemma. We managed to deliver the baby safely through cesarean section at week 28 despite the critical condition of the mother. Unfortunately, the mother died 2 weeks post delivery. We concluded that although recurrent and treated GBM is rarely associated with pregnancy and carries dismal prognosis, but if it occurs, it can still be carried, and a multidisciplinary team work is the key for successful outcome.
Department of Medical Oncology, Princess Norah Oncology Center, Jeddah, Kingdom of Saudi Arabia.
Intisar M
IM
Al-Rasheedy
Fahad M
FM
Al-Hameed
D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D005260:Female; D005333:Fetus / Q000187:drug effects / Q000528:radiation effects; D005909:Glioblastoma / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000628:therapy*