Highlights
- •Reciprocal effects between pregnancy and hemangioblastomas were not thoroughly clear.
- •Symptomatic treatment was the first choice for these patients, especially for those with spinal hemangioblastoma.
- •Safe urgent tumor resection was possible with careful maternal and fetal monitoring if necessary.
- •Both maternal and born fetal prognoses were favorable in the long run.
Abstract
The study aims to assess the management and maternal and fetal outcomes of pregnancies
complicated by central nervous system (CNS) hemangioblastoma. Twenty-four female patients
with CNS hemangioblastoma, who were pregnant in a tumor-burden status, were identified.
Their medical charts, treatments, and follow-up materials were carefully reviewed.
Of the included 24 CNS patients with hemangioblastoma (14 intracranial and 10 spinal
hemangioblastomas), 5 patients (20.8%) were diagnosed with Von Hippel-Lindau disease
(VHL). The median age of these patients at admission was 27.5 years. Intracranial
hypertension was a common presenting symptom for patients with intracranial hemangioblastoma
and was observed in 85.7% (12/14) of cases; the other 10 patients with spinal hemangioblastomas
all suffered from paresthesia. Overall, 66.7% (16/24) of patients with CNS hemangioblastoma
went through the gestational course with conventional observation; 16.6% (4/24) of
patients accepted a ventriculo-peritoneal shunt (VPS) to delay the tumor resection;
and 16.7% (4/24) of patients needed urgent tumor resection even when symptomatic treatments
were given. Variable symptom improvement was seen when patients had follow-up visits
at a median of 32.5 months. No maternal death or tumor recurrence was identified.
For the fetal prognoses, one (4.2%) pregnancy ended in a spontaneous miscarriage and
for (16.7%) pregnancies were interrupted; the other 19 (79.2%) live births were in
good status without any congenital malformations. Symptomatic treatment was the first
choice for pregnant patients with CNS hemangioblastoma. When needed, urgent tumor
resection could be safely achieved with careful maternal and fetal monitoring. Both
maternal and fetal prognoses were favorable during follow-up.
Keywords
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References
- Cancer during pregnancy: an analysis of 215 patients emphasizing the obstetrical and the neonatal outcomes.J Clin Oncol. 2010; 28: 683-689
- Pregnancy-related primary brain and spinal tumors.Arch Neurol. 1987; 44: 209-215
- Recurrence of cystic part of cerebellar hemangioblastoma at early postoperative period and its spontaneous resolution: a pregnant patient with serial magnetic resonance imaging findings.J Neurol Sci. 2012; 29: 385-392
- Surgical management of cerebellar hemangioblastomas in patients with von Hippel-Lindau disease.J Neurosurg. 2008; 108: 210-222
- Pregnancy-related hemangioblastoma progression and complications in von Hippel-Lindau disease.Neurology. 2012; 79: 793-796
- Effect of pregnancy on hemangioblastoma development and progression in von Hippel-Lindau disease.J Neurosurg. 2012; 117: 818-824
- New von Hippel-Lindau manifestations develop at the same or decreased rates in pregnancy.Neurology. 2015; 85: 1500-1503
- Brain tumor and pregnancy.Obstet Gynecol. 1997; 89: 19-23
- The microsurgical removal of intramedullary spinal hemangioblastomas. Report of twelve cases and a review of the literature.Surg Neurol. 1976; 6: 141-148
- Diagnosis and surgical treatment of brainstem hemangioblastomas.Surg Neurol. 2005; 63 (discussion 315-6): 307-315
- von Hippel-Lindau disease: a clinical and scientific review.Eur J Hum Genet. 2011; 19: 617-623
- The natural history of hemangioblastomas of the central nervous system in patients with von Hippel-Lindau disease.J Neurosurg. 2003; 98: 82-94
- Management strategy for meningioma in pregnancy: a clinical study.Skull Base. 2003; 13: 197-203
- Management strategy for brain tumour diagnosed during pregnancy.Br J Neurosurg. 2011; 25: 225-230
- Posterior fossa surgery in the sitting position in a pregnant patient with cerebellopontine angle meningioma.Br J Anaesth. 1999; 82: 941-944
- Management of foramen magnum meningioma during pregnancy: literature review and case report.World Neurosurg. 2017; 97: 752e15-752e18
- Anaesthesia for non-obstetric surgery during pregnancy.Indian J Anaesth. 2016; 60: 234-241
- Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth.Cochrane Databaseb Syst Rev. 2013; 8: CD006764
- Pregnancy complicated by von Hippel-Lindau disease.Obstet Gynecol. 1995; 85: 829-831
- Pregnancy in women with gliomas: a case-series and review of the literature.J Neurooncol. 2013; 115: 293-301
- Cerebellar hemangioblastoma symptomatic during pregnancy: a short review.Am J Clin Neurol Neurosurg. 2016;
- Pregnancy in von Hippel-Lindau disease.Am J Obstet Gynecol. 1999; 180: 110-111
Article info
Publication history
Published online: September 24, 2018
Accepted:
August 8,
2018
Received:
May 8,
2018
Identification
Copyright
© 2018 Published by Elsevier Ltd.
