RESUMO
INTRODUCTION: Fetal intracranial tumors are rare and their evolution is usually poor. With routine use of antenatal ultrasound imaging, a larger number of such tumors have been diagnosed. METHODS: During the period from January 1992 to January 2002, 18 cases diagnosed as intracranial tumors in the fetal stage were treated in the Neurosurgery and Obstetrics Departments of the Federal University of São Paulo and in the Fetal Medicine Service of the Maternity Hospital Santa Joana. RESULTS: The tumors most frequently found were those of the choroid plexus and teratomas. Out of those 18 cases, 11 patients presented with fetal hydrocephalus, and 5 of them, who were less than 34 weeks old (gestational age), underwent repeated cephalocenteses while awaiting better conditions for delivery. Two fetuses died while in utero before any intervention had taken place and 16 underwent craniotomy after birth. Twelve of those patients are still alive, 9 of whom are considered normal. The 3 others are slightly or moderately retarded.
Assuntos
Neoplasias Encefálicas/diagnóstico , Hidrocefalia/diagnóstico , Diagnóstico Pré-Natal , Resultado do Tratamento , Amniocentese , Astrocitoma , Encefalopatias/complicações , Encefalopatias/patologia , Encefalopatias/cirurgia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/embriologia , Neoplasias Encefálicas/cirurgia , Criança , Pré-Escolar , Cistos , Feminino , Feto , Idade Gestacional , Hemorragia/patologia , Humanos , Hidrocefalia/complicações , Hidrocefalia/embriologia , Hidrocefalia/cirurgia , Lactente , Imageamento por Ressonância Magnética/métodos , Masculino , Gravidez , Prognóstico , Ultrassonografia Pré-NatalRESUMO
The germinoma represents a less malignant form of germ cell tumor. Depending on the individual's age, this neoplasm constitutes approximately 0.1% to 3.4% of all intracranial tumors. The embryologic origin remains a mystery; however, current theories implicate an aberration in primordial germ cell migration. Clinical presentation depends on tumor location and may involve endocrine, hypothalamic, visual, and cognitive dysfunction. In evaluating midline intracerebral masses, it is imperative that one be aware of the various radiologic appearances, endocrinologic changes, and chemical markers that help to distinguish germinomas from other neoplasms that appear in the pineal, suprasellar, and periventricular regions. Only through the careful evaluation of all available studies can the physician institute appropriate therapies such as biopsy, radiation, and chemotherapy. This article focuses on the epidemiology, embryology, clinical presentation, means of diagnosis, treatment, and outcome of this rare neoplasm.
Assuntos
Neoplasias Encefálicas/diagnóstico , Disgerminoma/diagnóstico , Neoplasias Encefálicas/embriologia , Neoplasias Encefálicas/terapia , Disgerminoma/embriologia , Disgerminoma/terapia , Humanos , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/embriologia , Neoplasias da Medula Espinal/terapiaRESUMO
A large intracranial teratoma which replaced the entire brain is described in an hydrocephalic foetus which was aborted at the 25th week of gestation. This very rare condition is reported for the first time in the Caribbean literature (AU)