title: Rapid malignant transformation of low-grade astrocytoma in a pregnant woman.
abstract: We report rapid malignant transformation of diffuse astrocytoma to glioblastoma during pregnancy in a young woman. A 21-year-old woman was found to have a non-enhancing right frontal lesion, supposed to be a low-grade astrocytoma according to magnetic resonance imaging (MRI) studied for chronic headache. Due to the absence of clinical symptoms, the patient refused further investigations and delivered a baby and then became pregnant with a second baby. At first, she refused the biopsy because she was afraid, although the size of the lesion on MRI was increasing; however, due to repeated persuasion, she underwent a biopsy during the 4th month of her second gestation, with a result of diffuse astrocytoma (WHO grade II). At 1 month after the second delivery and 6 months after the biopsy, MRI revealed further enlargement of the tumor and a heterogeneous kenhancement effect. A gross tumor removal was carried out, and the tumor was histologically diagnosed as glioblastoma (WHO grade IV). This is the quickest ever malignant transformation of diffuse astrocytoma during pregnancy in the published reports.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. hanat@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hanada
authors.affiliation: Department of Neurosurgery, Diponegoro University, Dr. Kariadi Hospital, Semarang, Indonesia.
authors.forename: Tri Uji
authors.initials: TU
authors.lastname: Rahayu
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamahata
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hirano
authors.affiliation: Departement of Pathology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Yoshioka
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Arita
mesh_terms: D001254:Astrocytoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D001706:Biopsy; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002471:Cell Transformation, Neoplastic; D018450:Disease Progression; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D060787:Neoplasm Grading; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
keywords: diffuse astrocytoma; glioblastoma multiforme; malignant transformation; pregnancy