Type:
Educational Exhibit
Keywords:
Foetus, Congenital, Diagnostic procedure, Contrast agent-intravenous, Ultrasound, MR, CT, Paediatric, Neuroradiology brain, CNS
Authors:
I. Popescu, V. M. Marcu, M. C. Coman, S. Tarnoveanu, C. Cirstoveanu, S. Stoica ; Bucharest/RO
DOI:
10.1594/ecr2013/C-0882
Background
Primary central nervous system (CNS) tumors are a common group of neoplasms in the pediatric population,
being second only to leukemia in frequency.
CNS tumors of the fetus represent only 10% of all antenatal tumors,
ranking behind extracranial teratomas,
neuroblastomas,
and soft-tissue tumors.
Intracranial teratoma is the most common fetal brain tumor,
accounting for approximately half of all reported cases.
It is followed in frequency by astrocytomas of varying grades,
lipomas,
choroid plexus papillomas,
craniopharyngiomas,
and primitive neuroectodermal tumors.
With regard to anatomic distribution,
the majority of fetal CNS tumors are supratentorial.
Congenital brain tumors most commonly arise from the pineal gland,
suprasellar area,
or cerebral hemispheres; however,
imaging or even autopsy are frequently unable to determine the origin of these lesions.
The tumors most commonly become clinically manifest in the third trimester of pregnancy,
sometimes in patients with a normal ultrasound (US) scan obtained recently as 2 weeks before the clinical diagnosis.
Diagnosis earlier in pregnancy,
particularly before 30 weeks gestation,
portends a particularly deleterious prognosis,
with reported mortality rates as high as 96.9%.
(1)