Bunevicius Adomas, Matukevicius Algimantas, Deltuva Vytenis, Gudinaviciene Inga, Pranys Darius, Tamasauskas Arimantas
Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Neurosurgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Neurosurgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
World Neurosurg. 2018 May;113:129-134. doi: 10.1016/j.wneu.2018.02.012. Epub 2018 Feb 13.
In vitro fertilization (IVF) is increasingly used for the treatment of infertile couples worldwide. The association between IVF and cancer risk in offspring is conflicting. We present a case of atypical teratoid/rhabdoid tumor (AT/RT) in a girl conceived by IVF and present results of systematic review of literature of primary intracranial neoplasms diagnosed in children conceived by IVF.
A systematic review of literature was conducted on April 12, 2017, to identify previously published reports of intracranial brain tumors in patients conceived after IVF.
A 21-month-old girl born after IVF and uneventful pregnancy presented with progressive nausea, vomiting, irritability, and right-side weakness. Magnetic resonance imaging demonstrated large heterogeneous contrast enhancing left frontotemporoparietal tumor. The operation was aborted due to asystole after subtotal tumor removal. The patient passed away on postoperative day 3. Histologic examination demonstrated AT/RT. We identified 7 previously published case reports of intracranial neoplasms in children conceived by IVF. Patient age at brain tumor diagnosis ranged from 31st week of gestation to 3 years of age. The most common histological diagnosis was AT/RT (3 cases), followed by glioblastoma multiforme, gliosarcoma, medulloblastoma, craniopharyngioma, and choroid plexus papilloma. Three of five operated patients died during perioperative period. Outcomes were dismal in 7 patients.
IVF-associated brain tumors are usually malignant and associated with high mortality. Future studies investigating possible causal relationship between IVF and brain tumor risk are encouraged.
体外受精（IVF）在全球范围内越来越多地用于治疗不孕夫妇。IVF与后代患癌风险之间的关联存在争议。我们报告了一例通过IVF受孕的女孩患非典型畸胎样/横纹肌样瘤（AT/RT）的病例，并呈现了对通过IVF受孕的儿童中诊断出的原发性颅内肿瘤的文献系统综述结果。
于2017年4月12日对文献进行系统综述，以确定先前发表的关于IVF后受孕患者颅内脑肿瘤的报告。
一名通过IVF出生且孕期正常的21个月大女孩出现进行性恶心、呕吐、易怒和右侧肢体无力。磁共振成像显示左额颞顶叶有一大块不均匀强化的肿瘤。肿瘤大部分切除后因心脏停搏手术中止。患者于术后第3天死亡。组织学检查显示为AT/RT。我们确定了7例先前发表的关于IVF受孕儿童颅内肿瘤的病例报告。脑肿瘤诊断时的患者年龄从妊娠第31周至3岁不等。最常见的组织学诊断是AT/RT（3例），其次是多形性胶质母细胞瘤、胶质肉瘤、髓母细胞瘤、颅咽管瘤和脉络丛乳头状瘤。5例接受手术的患者中有3例在围手术期死亡。7例患者的预后都很糟糕。
与IVF相关的脑肿瘤通常是恶性的，且死亡率高。鼓励未来开展研究调查IVF与脑肿瘤风险之间可能的因果关系。
