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Brain tumors in pregnancy
1University of Connecticut Health Center, Department of Surgery, Farmington 06032.
There seems to be no higher incidence of primary brain tumor in pregnancy. There are no extracranial tumors that are likely to metastasize that are uniquely related to the specific pregnancy. Choriocarcinoma during the index pregnancy is rare. Although pregnancy-related choriocarcinoma has a high propensity for brain metastasis, it is in the postpartum period or later that such tumors and their metastases present. The fetus seems to be spared from any complications resulting from maternal tumor, provided that it is safely delivered. There is a rich literature on the immunology and steroid receptor pharmacology of brain tumor but alterations in immunity or in receptor sites seem to have little impact on the incidence of tumors during pregnancy. There may be modification of the behavior of brain tumors by pregnancy and hence possibly by steroid hormones. The principle governing management of the mother is primarily common sense. As the ability to manage brain tumors in general improves, the necessity of interfering with either the pregnancy or mode of delivery evaporates.
There seems to be no higher incidence of primary brain tumor in pregnancy. There are no extracranial tumors that are likely to metastasize that are uniquely related to the specific pregnancy. Choriocarcinoma during the index pregnancy is rare. Although pregnancy-related choriocarcinoma has a high propensity for brain metastasis, it is in the postpartum period or later that such tumors and their metastases present. The fetus seems to be spared from any complications resulting from maternal tumor, provided that it is safely delivered. There is a rich literature on the immunology and steroid receptor pharmacology of brain tumor but alterations in immunity or in receptor sites seem to have little impact on the incidence of tumors during pregnancy. There may be modification of the behavior of brain tumors by pregnancy and hence possibly by steroid hormones. The principle governing management of the mother is primarily common sense. As the ability to manage brain tumors in general improves, the necessity of interfering with either the pregnancy or mode of delivery evaporates.