Unexpected and sudden death due to undiagnosed medulloblastoma in twin pregnancy: A case report.
The authors describe an unusual case of sudden and unexpected death caused by a medulloblastoma in a woman aged 28, native of South America, at the 33rd week of twin pregnancy, with neurological signs appeared a month before death. The initial symptoms were attributed to epiphenomena of pregnancy. Two weeks after hospitalization, the woman showed an acute frontal headache that prevented movement and caused a rapid lowering of arterial oxygen saturation. The patient died around 3h later, despite resuscitation. Immediately after, a caesarean section was performed but it was not enough to prevent the death of the two foetuses. The autopsy revealed the presence of a tumour between the left lobe of the cerebellum and the vermis. Histological examination enabled to identify a medulloblastoma. Death was attributed to acute cardio-respiratory insufficiency caused by compression of the brain stem. Foetuses showed no malformation and their death was due to an acute hypoxia resulting from the mother cardiovascular arrest.
Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132 Genova, Italy. Electronic address: francesco.ventura@unige.it.
Francesco
F
Ventura
Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132 Genova, Italy.
Rosario
R
Barranco
Clinical Pathology Service, San Vincenzo Hospital, Contrada Sirina, 98039 Taormina, Italy.
Raffaella
R
Gentile
Department of Obstetrics and Gynecology, University of Milano Bicocca, Fondazione MBBM, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, Italy.
Patrizia
P
Vergani
D000328:Adult; D002528:Cerebellar Neoplasms / Q000473:pathology*; D003645:Death, Sudden / Q000209:etiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D008527:Medulloblastoma / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology*; D059285:Pregnancy, Twin
Foetal hypoxia; Medulloblastoma; Pregnancy; Sudden death