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- Title
Congenital meningeal sarcoma - A case report.
- Authors
van Vliet, M. A. T.; Bravenboer, B.; Kock, H. C. L. V.; Teepen, J. L. J. M.
- Abstract
A 30-year-old multigravida woman was admitted to the obstetrical unit in the third trimester of gestation, because of a large-for-date uterus. Repeated ultrasonic examinations over a 2-week period revealed an increase in biparietal diameter far too large to be normal. This progressive asymmetrical hydrocephalus was diagnosed as caused by an intracranial space-occupying lesion in the middle cranial fossa. Because of the only minimal thickness of the cerebral cortex prognosis was jugded so poor, that labor was induced. A stillborn female infant was delivered vaginally after an ultrasonically guided transabdominal and later transcervical encephalocentesis. Autopsy revealed hydrocephalus and section through the fixed brain showed that the mentioned mass was an undifferentiated meningeal sarcoma that filled the left middle cranial fossa. Microscopically the sarcoma was invading the brain tissue. Definitions of the term "congenital brain-tumors" vary among authors. "Congenital" can be interpreted as "derived from embryonal tissue" or as "originating in utero". Congenital intracranial neoplasms are very rare. Antenatally intracranial tumors have been reviewed by WELLS, SOLITARE and FARWELL. Only a few cases of congenital brain tumors arising in the meninges have been reported in these reviews. The genesis of the tumor is explained as derived from multipotential cells. The undifferentiated type of a meningeal sarcoma has a poor prognosis. Most meningeal sarcoma present with progressive hydrocephalus. The strategy highly depends on the prognosis which is directly related to the type, size and location of the tumor and to the remaining thickness of the cerebral cortex. In our case the prognosis was jugded extremely poor. Cesarean section could be avoided by decompression of the fetal head by transabdominal encephalocentesis guided by ultrasound. When antenatal ultrasonography is applied routinely it can be expected that problems concerning the management of fetal abnormalities will present themselves with increasing frequency.
- Publication
Journal of Perinatal Medicine, 1983, Vol 11, Issue 5, p249
- ISSN
0300-5577
- Publication type
Article