Primitive neuroectodermal tumor (PNET) of the brain diagnosed during pregnancy

Brain tumors in pregnancy are extremely rare events. A case of a patient with primitive neuroectodermal tumor (PNET) of the brain diagnosed during the second half of pregnancy is reported.

The first case of PNET of the brain diagnosed in a 26-year-old woman, gravida 1 para 0, in her 20th week of pregnancy is presented. The patient presented with headache, nausea and blurred vision. Magnetic resonance imaging revealed a large ill-defined tumoral mass in the left frontal cortex. Gross subtotal resection was achieved via a left frontal craniotomy. Pathological evaluation revealed histology and immuno-histochemistry consistent with the diagnosis of PNET. Adjuvant radiation therapy to the neurocranium was administered. Additionally, chemotherapy with Temodal 5 mg (Temozolomid) was initiated at 30 weeks of gestation. The patient delivered her baby via Cesarean section at 34 weeks of gestation. After delivery, external beam radiation to the craniospinal axis completed the therapy. The patient is currently being followed-up at the Department of Oncology University of Vienna Medical School, without any evidence of disease, 3 months after diagnosis.

This case is the first reported description of a PNET in pregnancy. A brief discussion of this rare disease and its management in pregnancy is presented. The treatment options seem to be reduced in pregnant women and mainly depend on the patient's condition as well as the gestational age at presentation. In a multidisciplinary approach, an optimal therapy schedule should be assessed depending on these two parameters.