Hanada Tomoko, Rahayu Tri Uji, Yamahata Hitoshi, Hirano Hirofumi, Yoshioka Takako, Arita Kazunori
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Department of Neurosurgery, Diponegoro University, Dr. Kariadi Hospital, Semarang, Indonesia.
J Obstet Gynaecol Res. 2016 Oct;42(10):1385-1389. doi: 10.1111/jog.13072. Epub 2016 Jun 30.
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.
我们报告了一名年轻女性在怀孕期间弥漫性星形细胞瘤迅速恶变为胶质母细胞瘤的病例。一名21岁女性因慢性头痛接受磁共振成像（MRI）检查，发现右侧额叶有一个无强化病灶，根据MRI推测为低级别星形细胞瘤。由于没有临床症状，患者拒绝进一步检查并产下一名婴儿，随后再次怀孕。起初，尽管MRI上病灶大小在增大，但她因害怕而拒绝活检；然而，经过反复劝说，她在第二次妊娠的第4个月接受了活检，结果为弥漫性星形细胞瘤（世界卫生组织二级）。在第二次分娩后1个月以及活检后6个月，MRI显示肿瘤进一步增大且有不均匀强化效应。进行了肿瘤全切，组织学诊断为胶质母细胞瘤（世界卫生组织四级）。这是已发表报告中孕期弥漫性星形细胞瘤最快的恶性转化病例。
