Case report and literature review: antenatal diagnosis of a fetal anaplastic astrocytoma

J Matern Fetal Neonatal Med. 2022 Dec;35(25):6631-6637. doi: 10.1080/14767058.2021.1918668. Epub 2021 May 9.

Abstract

Objectives: To describe the ultrasonographic appearance of congenital anaplastic astrocytoma, so as to provide diagnostic clues for it. An updated review of the literature was also carried out.

Results: There was a case of fetal anaplastic astrocytoma detected by ultrasound at 37 + 1 weeks of gestation. It showed that a hypoechoic mass was located in the left hemisphere with a relatively clear margin and subtle color flows. Prenatal magnetic resonance imaging (MRI) which was taken subsequently confirmed the result of ultrasound. Intratumoral hemorrhage was observed in later follow-up and further confirmed by histological examination. The fetus was delivered vaginally at 39 + 6 weeks. The infant died 2 h after delivery due to respiration failure. The histological examination confirmed an anaplastic astrocytoma.

Conclusions: Congenital anaplastic astrocytoma commonly detected by ultrasound has a relatively better perinatal prognosis, especially compared with glioblastoma. Prenatal ultrasonography diagnosis accurately is of critical importance. The anaplastic astrocytoma should be considered in cases in which fetal images reveal a heterogeneous echogenic mass in the brain, especially in the presence of intratumoral hemorrhage, subtle color flow, and relatively clear margin.

Keywords: Fetus; fetal anaplastic astrocytoma; intracranial neoplasms; prenatal imaging; ultrasonography.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Astrocytoma* / diagnostic imaging
  • Astrocytoma* / pathology
  • Brain Neoplasms* / congenital
  • Female
  • Fetus / diagnostic imaging
  • Glioblastoma* / pathology
  • Hemorrhage
  • Humans
  • Magnetic Resonance Imaging / methods
  • Pregnancy
  • Prenatal Diagnosis / methods
  • Ultrasonography, Prenatal / methods