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Peripheral primitive neuroectodermal tumour during pregnancy.

H Varveris1, M Mazonakis, J Damilakis

  • 1Departments of Radiotherapy & Oncology, Medical Physics, Histopathology, Obstetrics and Gynecology and Clinical Oncology, Iraclion University Hospital, School of Medicine, 71110 Iraclion, Crete, Greece.

The British Journal of Radiology
|July 19, 2002
PubMed
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A pregnant patient with a primitive neuroectodermal tumor (pPNET) underwent radiation and early delivery. While the infant was disease-free, the mother succumbed to aggressive tumor metastasis.

Area of Science:

  • Oncology
  • Obstetrics & Gynecology
  • Pathology

Background:

  • Peripheral primitive neuroectodermal tumors (pPNET) are rare and aggressive malignancies.
  • Pregnancy with a concurrent PNET diagnosis presents unique management challenges for both mother and fetus.

Observation:

  • A 25-year-old primipara in her second trimester was diagnosed with pPNET.
  • Cerebral radiotherapy with fetal shielding and subsequent cesarean delivery at 27 weeks gestation were performed due to tumor progression.
  • Metastases were found in the placenta and ovaries of the neonate, who survived for 1 month.

Findings:

  • The neonate showed no initial evidence of disease.
  • The maternal pPNET demonstrated rapid and extensive dissemination, including bone marrow, lung, liver, and craniospinal axis involvement.

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  • Despite treatment interventions, the patient died 14 months post-diagnosis due to tumor aggressiveness and treatment limitations.

    • Implications:

    • This case highlights the critical challenges in managing aggressive maternal malignancies during pregnancy.
    • The findings underscore the potential for transplacental metastasis of pPNET, even with protective measures.
    • Further research is needed to optimize treatment strategies for pregnant patients with PNET to improve maternal and fetal outcomes.