Medulloblastoma in pregnancy

Case contributed by Saeed Soltany Hosn
Diagnosis certain

Presentation

17 weeks pregnant, presented with a severe acute headache. Her past medical history was unremarkable.

Patient Data

Age: 20 years
Gender: Female
mri

There is a well defined heterogenous lobulated mass hypo-  to isointense on T1 WI and slightly hyperintense on T2WI, with mild perilesional edema and a marked heterogenous contrast enhancement in the right cerebellar hemisphere. There is also marked dilatation of the lateral ventricles including the temporal horns and bowing of the corpus callosum indicating obstructive tetra-ventricular hydrocephalus. There is also some degree of transependymal migration of CSF surrounding the ventricles on T2/FLAIR sequences. Extra-axial CSF spaces are not distended. Note the mild leptomeningeal enhancement. Also, note the inferior herniation of the cerebellar tonsils, bilateral optic nerve sheath dilation,  and acquired chiari, are resulted in the mass effect of the tumor. 

Opacification of the left maxillary and sphenoid sinuses are incidental findings.

 

The postoperative CT scan reveals evidence of craniotomy and a decrease of pressure effect. 

Case Discussion

She underwent termination of pregnancy prior to craniotomy. Surgical pathology confirmed the case as medulloblastoma.

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