Isla A, Alvarez F, Gonzalez A, García-Grande A, Perez-Alvarez M, García-Blazquez M
Services of Neurosurgery, Gynecology, and Radiotherapy, Hospital, La Paz, Madrid, Spain.
Obstet Gynecol. 1997 Jan;89(1):19-23. doi: 10.1016/s0029-7844(96)00381-x.
To establish the indications for surgical intervention, at the appropriate gestational duration, for brain tumors in pregnant women, and to evaluate any association pregnancy hormones may have with the rate of growth or development of complications of brain tumors.
We observed seven women with brain tumors associated with pregnancy in a series of 126,413 pregnancies from 1983 to 1995. One woman presented with symptoms of intracranial hypertension, and neurologic signs were the first symptoms in two other women. One woman presented with a sudden hemorrhagic lesion, and three had focal seizures. All were evaluated with computed tomography, magnetic resonance imaging, or both.
Six of the seven women had surgery; the seventh was treated with radiotherapy because the neuroradiologic studies suggested a quickly growing brainstem glioma. Diagnoses were confirmed on histology in six women: two with meningiomas, two with ependymomas, and two with low-grade astrocytomas (one of these had multiple astrocytomas). Estrogen and progesterone receptors were studied in two cases (one meningioma and one astrocytoma) and were present in both.
Management of brain tumors should be tailored to the individual patient. There may be a relation between pregnancy hormones and the rate of brain tumor growth mediated through specific intracellular receptors.
确定孕妇脑肿瘤在合适孕周进行手术干预的指征，并评估妊娠激素与脑肿瘤生长速度或并发症发生发展之间的关联。
在1983年至1995年的126413例妊娠中，我们观察了7例合并脑肿瘤的孕妇。1例出现颅内高压症状，另外2例以神经系统体征为首发症状。1例出现突发出血性病变，3例有局灶性癫痫发作。所有患者均接受了计算机断层扫描、磁共振成像或两者检查。
7例患者中有6例接受了手术；第7例因神经放射学检查提示脑干胶质瘤生长迅速而接受了放射治疗。6例患者的诊断经组织学证实：2例为脑膜瘤，2例为室管膜瘤，2例为低级别星形细胞瘤（其中1例为多发星形细胞瘤）。对2例患者（1例脑膜瘤和1例星形细胞瘤）进行了雌激素和孕激素受体研究，两者均有表达。
脑肿瘤的治疗应因人而异。妊娠激素与通过特定细胞内受体介导的脑肿瘤生长速度之间可能存在关联。
