Pregnant patient presenting with headache and medulloblastoma and hydrocephalous: a case report

Swati Sharma, Archana Tripathi

Abstract


Medulloblastoma, a primitive neuroectodermal tumor (PNET), is a second most brain tumor in children, accounting for about 20% of cases but is very rare in adults, 1% of all cancers in adults with only one third of cases occur in women and even less in pregnant women. It is primarily a cerebellar tumor. Symptoms include nausea, vomiting, loss of coordination, morning headache, seizures and personality changes. Treatment is surgical removal of tumor followed by radiotherapy. A grand-multipara presented in casualty with 30 weeks pregnancy & complains of headache, visual disturbances & disorientation. MRI findings were suggestive of medulloblastoma with hydrocephalus. Ventriculo-peritoneal shunting was done followed by termination of pregnancy. She delivered vaginally a live female child. After 15 days, her definitive neurosurgery was done. The uniqueness of this case is its rarity and symptoms of which are often masked by symptoms of pregnancy as syncope during pregnancy could be due to hypoglycemia, anxiety, orthostatic hypotension or cardiac causes.


Keywords


Medulloblastoma, Hydrocephalus, Pregnancy

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References


Adult medulloblastoma. Holland - Frei cancer medicine. Hamilton, ON: BC Decker, 2003. Available at: http:/www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed6∂=A19676. Accessed July 2010.

Oliver TG, Grasfeder LL, Carroll AL, Kaiser C, Gillingham CL, Lin SM et al. Transcriptional profiling of the sonic hedgehog response; a critical role for N-myc in proliferation of neuronal precursors. Proc Natl Acad Sci. USA. 2003;100(12):7331-6.

Sasai K, Romer JT, Lee Y, Finkelstein D, Fuller C, Mckinnon PJ et al. Shh pathway is downregulated in cultured medulloblastoma cells: implications for preclinical studies. Cancer Res. 2006 Apr 15;66(8):4215-22.

Belcher SM, Ma X, Le HH. Blockade of estrogen receptors signaling inhibits growth and migration of medulloblastoma. Endocrinology. 2009;150(3):1112-21.

The American Pregnancy Association. Pregnancy and dizziness, 2007. Available at: http://www.americanpregnancy.org/pregnacyhealth/dizziness.html. Accessed July 2010.

Ismail K, Coakham HB, Walters JM. Intracranial meningioma with progesterone positive receptors in late pregnancy. Eur J Anaesthesiol. 1998;15(1):106-9.

Morag R, Brenner B. Syncope: differential diagnosis & workup. Emedicine, 2010. Available at: http;//emedicine.medscape.com/article/811669-differential. Accessed 13 April 2011.