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妊娠期间变性星形细胞瘤:有效多学科方法的重要性。

Anaplastic astrocytoma during pregnancy: the importance of an effective multidisciplinary approach.

作者信息

Filippi Valeria, Leu Severina Maria, Marengo Luca, Hoesli Irene

机构信息

Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland

Neurosurgery, University Hospital Basel, Basel, Switzerland.

出版信息

BMJ Case Rep. 2021 Apr 1;14(4):e242135. doi: 10.1136/bcr-2021-242135.

Abstract

A 34-year-old pregnant woman at 28 gestational weeks was diagnosed with a brain tumor after experiencing a generalised seizure. After completion of antenatal fetal lung maturation, she underwent an osteoplastic craniotomy parietal on the left side and a microsurgical partial tumor resection under general anaesthesia. With a histology of a diffuse astrocytoma and the postoperative stable amount of residual tumor on follow-up imaging, the pregnancy proceeded until 37 gestational weeks. A healthy baby boy was delivered by elective caesarean section. An awake craniotomy for removal of the residual tumor was planned two weeks later, followed by adjuvant treatment (combined radio-/chemotherapy). A multidisciplinary approach, combined with appropriate timing and a transparent and empathic communication, was able to create the most effective tailored management and optimise maternal and neonatal outcomes.

摘要

一名28孕周的34岁孕妇在发生全身性癫痫发作后被诊断出患有脑肿瘤。在完成产前胎儿肺成熟后,她在全身麻醉下接受了左侧顶骨骨成形开颅术和显微外科部分肿瘤切除术。组织学检查为弥漫性星形细胞瘤,随访影像学显示术后残留肿瘤量稳定,妊娠持续至37孕周。通过择期剖宫产分娩出一名健康男婴。计划在两周后进行清醒开颅手术以切除残留肿瘤,随后进行辅助治疗(联合放疗/化疗)。多学科方法,结合适当的时机以及透明且富有同理心的沟通,能够制定出最有效的个性化管理方案,并优化母婴结局。

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本文引用的文献

1
Clinical challenges of glioma and pregnancy: a systematic review.胶质瘤与妊娠的临床挑战:系统综述。
J Neurooncol. 2018 Aug;139(1):1-11. doi: 10.1007/s11060-018-2851-3. Epub 2018 Apr 6.
3
The effect of pregnancy on survival in a low-grade glioma cohort.妊娠对低级别胶质瘤队列生存的影响。
J Neurosurg. 2016 Aug;125(2):393-400. doi: 10.3171/2015.6.JNS15985. Epub 2016 Jan 1.
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Pregnancy and glial brain tumors.妊娠与胶质脑肿瘤
Neuro Oncol. 2014 Sep;16(9):1289-94. doi: 10.1093/neuonc/nou019. Epub 2014 Mar 9.
8
Obstetric outcomes of women with intracranial neoplasms.患有颅内肿瘤的女性的产科结局。
Int J Gynaecol Obstet. 2009 Apr;105(1):56-9. doi: 10.1016/j.ijgo.2008.11.037. Epub 2009 Jan 19.

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