Naqvi Syeda Mariam Zehra, Shafique Mehwish, Akram Asma, Saleem Huma
Anesthesiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Lahore, PAK.
Cureus. 2025 Jul 24;17(7):e88677. doi: 10.7759/cureus.88677. eCollection 2025 Jul.
We report an unusual case of a 26-year-old female patient diagnosed with primary intracranial Ewing sarcoma (ES) at 16 weeks' gestation. She had vertigo, vomiting, and worsening visual disturbances. MRI showed a solid-cystic mass in the left occipital area with a midline shift. Neurosurgical resection was performed under general anesthesia, with careful intraoperative management to ensure maternal stability and fetal safety. Unique considerations in our anesthesia technique for pregnancy were the management of cerebral blood flow, increased intracranial pressure, and avoiding teratogenic medications. Throughout the intraoperative period, maternal hemodynamic parameters were closely tailored, at times requiring transfusion due to significant bleeding. Postoperative CT imaging showed standard imaging changes consistent with surgical resection and no immediate complications. Fetal monitoring via obstetric ultrasound was normal. Results of histopathology confirmed ES. Here, we discuss the rarity of an intracranial ES occurring during pregnancy and the contours of anesthesia practice in this patient with a complex perioperative process. Coordinating care and developing an individualized plan is crucial to support the best outcome for the mother and fetus.
我们报告了一例罕见病例，一名26岁女性患者在妊娠16周时被诊断为原发性颅内尤文肉瘤（ES）。她出现眩晕、呕吐及视力障碍加重。磁共振成像（MRI）显示左枕叶区域有一个实性囊性肿块，伴有中线移位。在全身麻醉下进行了神经外科手术切除，术中进行了仔细管理以确保母体稳定和胎儿安全。我们针对该孕妇的麻醉技术中的独特考虑因素包括脑血流管理、颅内压升高以及避免使用致畸药物。在整个手术过程中，密切调整母体血流动力学参数，有时因大量出血需要输血。术后计算机断层扫描（CT）成像显示符合手术切除的标准影像变化，且无即刻并发症。通过产科超声进行的胎儿监测正常。组织病理学结果证实为ES。在此，我们讨论妊娠期间发生颅内ES的罕见性以及该患者围手术期过程复杂的麻醉实践要点。协调护理并制定个性化计划对于为母亲和胎儿争取最佳结局至关重要。
