Fetal brain tumors: a review of 154 cases

The purpose of this literature review is to describe the various types of brain tumors that occur in the fetus, their locations, initial findings, pathology, and outcome. Data are presented that show which patients are likely to survive or benefit from treatment compared with those who are unlikely to respond. An analysis is performed on patients with fetal brain tumors that were detected prenatally by imaging studies or discovered directly after birth. The review revealed 154 fetuses presenting with brain tumors. Teratoma was the leading neoplasm. Next was astrocytoma followed by craniopharyngioma, primitive neuroectodermal tumor, choroid plexus papilloma, meningeal tumors, and ependymoma. The most common presenting findings were macrocephaly and an intracranial mass. Overall hydrocephalus was next, followed by stillbirth. Most tumors were detected during the third trimester of pregnancy. Over a third of the affected fetuses were stillborn. Many tumors were inoperable as they occupied much of the intracranial cavity and involved large areas of the brain. Overall survival rate was 23/154, or 15%. Generally fetal brain tumors are associated with a poor prognosis.