Primary brain tumours, meningiomas and brain metastases in pregnancy: report on 27 cases and review of literature

Eur J Cancer. 2014 May;50(8):1462-71. doi: 10.1016/j.ejca.2014.02.018. Epub 2014 Mar 14.

Abstract

Background: The concurrence of intracranial tumours with pregnancy is rare. The purpose of this study was to describe all reported patients registered in the international Cancer in Pregnancy registration study (CIP study; http://www.cancerinpregnancy.org), and to review the literature in order to obtain better insight into outcome and possibilities of treatment in pregnancy.

Methods: We collected all intracranial tumours (primary brain tumour, cerebral metastasis, or meningioma) diagnosed during pregnancy, registered prospectively and retrospectively by international collaboration since 1973. Patients diagnosed postpartum were excluded. We summarised the demographic features, treatment decisions, obstetrical and neonatal outcomes.

Results: The mean age of the 27 eligible patients was 31years (range 23-41years), of which 13 and 12 patients were diagnosed in the second and third trimesters, respectively. Eight patients (30%) underwent brain surgery, seven patients (26%) had radiotherapy and in three patients (11%) chemotherapy was administered during gestation. Two patients died during pregnancy and four pregnancies were terminated. In 16 (59%) patients elective caesarean section was performed of which 14 (52%) were still preterm (range 30-36weeks, mean 33weeks). Five patients had a vaginal delivery (range 36-40weeks). Of the 21 ongoing pregnancies all children were born alive without visible congenital malformations and the available long-term follow-up data (range 2-25years) of six children were reassuring.

Conclusion: Adherence to standard protocol for the treatment of brain tumours during pregnancy appears to allow a term delivery and a higher probability of a vaginal delivery.

Keywords: Brain tumour; Chemotherapy; Pregnancy; Radiotherapy; Surgery.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy
  • Delivery, Obstetric
  • Female
  • Humans
  • Meningeal Neoplasms / pathology*
  • Meningeal Neoplasms / therapy
  • Meningioma / pathology*
  • Meningioma / therapy
  • Pregnancy
  • Pregnancy Complications, Neoplastic*
  • Pregnancy Outcome
  • Prognosis
  • Prospective Studies
  • Registries
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult