Pineoblastoma is an extremely rare intracranial neoplasm, with increased risk of craniospinal metastasis. There is only one case reported in the literature who presented during pregnancy. Described here is a woman who presented at five months of gestation with recurrence of pineoblastoma, who had previously defaulted adjuvant therapy following surgical decompression. The challenges in the diagnosis and treatment of pineoblastoma and its effects on pregnancy are also discussed.
HerrickMKRubinsteinLJ.The cytological differentiating potential of pineal parenchymal neoplasms (true pinealomas). A clinicopathological study of 28 tumours. Brain1979;
102: 289–320.
2.
HartMNEarleKM.Primitive neuroectodermal tumors of the brain in children. Cancer1973;
32: 890–897.
3.
GenerMACongerARVan GompelJ, et al.
Clinical, pathological, and surgical outcomes for adult pineoblastomas. World Neurosurg2015;
84: 1816–1824.
4.
CucciaFMortellaroGCespuglioD, et al.
A case report of adult pineoblastoma occurring in a pregnant woman. Anticancer Res2019;
39: 2627–2631.
5.
TateMSughrueMERutkowskiMJ, et al.
The long-term postsurgical prognosis of patients with pineoblastoma: long-term survival in pineoblastoma. Cancer2012;
118: 173–179.
6.
LeeJYKWakabayashiTYoshidaJ.Management and survival of pineoblastoma: an analysis of 34 adults from the brain tumor registry of Japan. Neurol Med Chir2005;
45: 132–142.
7.
Committee on Obstetric Practice.Committee Opinion No. 723: guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol2017;
130: e210–6
8.
OatridgeAHoldcroftASaeedN, et al.
Change in brain size during and after pregnancy: study in healthy women and women with preeclampsia. AJNR Am J Neuroradiol2002;
23: 19–26.
9.
CipollaMJ.The adaptation of the cerebral circulation to pregnancy: mechanisms and consequences. J Cereb Blood Flow Metab2013;
33: 465–478. Apr
10.
VerheeckeMHalaskaMJLokCA, et al.
Primary brain tumours, meningiomas and brain metastases in pregnancy: report on 27 cases and review of literature. Eur J Cancer2014;
50: 1462–1471.
11.
NgJKitchenN.Neurosurgery and pregnancy. J Neurol Neurosurg Psychiatry2008;
79: 745–752.
12.
StevensonCBThompsonRC.The clinical management of intracranial neoplasms in pregnancy. Clin Obstet Gynecol2005;
48: 24–37.
13.
PalopRChoed-AmphaiEMillerR.Epidural anesthesia for delivery complicated by benign intracranial hypertension. Anesthesiology1979;
50: 159–160.
14.
HirsIGrbcicP.Cesarean section in spinal anesthesia on a patient with mesencephalic tumor and ventriculoperitoneal drainage – a case report. Korean J Anesthesiol2012;
63: 263–265.
15.
ChangSMLillis-HearnePKLarsonDA, et al.
Pineoblastoma in adults. Neurosurgery1995;
37: 90; discussion 390–391.
16.
FauchonFJouvetAPaquisP, et al.
Parenchymal pineal tumors: a clinicopathological study of 76 cases. Int J Radiat Oncol Biol Phys2000;
46: 959–968.
17.
KalbasiAKirkMTeoB-KK, et al.
Proton craniospinal irradiation during the third trimester of pregnancy. Pract Radiat Oncol2018;
8: 213–216.
18.
KalHBStruikmansH.Radiotherapy during pregnancy: fact and fiction. Lancet Oncol2005;
6: 328–333.
19.
PeccatoriFAAzimHAOrecchiaR, et al.
Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol2013;
24: 160–170.
20.
GalanisEBucknerJCSchombergPJ, et al.
Effective chemotherapy for advanced CNS embryonal tumors in adults. J Clin Oncol1997;
15: 2939–2944.
21.
AzimHAPeccatoriFAPavlidisN.Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: solid tumors. Cancer Treat Rev2010;
36: 101–109.
22.
Van CalsterenKVerbesseltROttevangerN, et al.
Pharmacokinetics of chemotherapeutic agents in pregnancy: a preclinical and clinical study. Acta Obstet Gynecol Scand2010;
89: 1338–1345.
23.
GhaemmaghamiFAbbasiFAbadiAGN.A favorable maternal and neonatal outcome following chemotherapy with etoposide, bleomycin, and cisplatin for management of grade 3 immature teratoma of the ovary. J Gynecol Oncol2009;
20: 257–259.
24.
CardonickEUsmaniAGhaffarS.Perinatal outcomes of a pregnancy complicated by cancer, including neonatal follow-up after in utero exposure to chemotherapy: results of an international registry. Am J Clin Oncol2010;
33: 221–228.
25.
ReynsNHayashiMChinotO, et al.
The role of Gamma Knife radiosurgery in the treatment of pineal parenchymal tumours. Acta Neurochir2006;
148: 5–11.
26.
LiWZhangBKangW, et al.
Gamma knife radiosurgery (GKRS) for pineal region tumors: a study of 147 cases. World J Surg Oncol2015;
13: 304
27.
JavalkarVPillaiPVannemreddyP, et al.
Gamma knife radiosurgery for arteriovenous malformations located in eloquent regions of the brain. Neurol India2009;
57: 617–621.
28.
YuCJozsefGApuzzoML, et al.
Fetal radiation doses for model C gamma knife radiosurgery. Neurosurgery2003;
52: 687–689.
29.
PantelisEAntypasCFrassanitoMC, et al.
Radiation dose to the fetus during CyberKnife radiosurgery for a brain tumor in pregnancy. Phys Med2016;
32: 237–241.
30.
PalledSKalavaguntaSBeerappa GowdaJ, et al.
Tackling a recurrent pinealoblastoma.Rep Oncol Med2014;
2014: 135435.
31.
StoiberEMSchaibleBHerfarthK, et al.
Long term outcome of adolescent and adult patients with pineal parenchymal tumors treated with fractionated radiotherapy between 1982 and 2003–a single institution's experience. Radiat Oncol2010;
5: 122.