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Pregnancy complicated by medulloblastoma with metastases to the placenta
R N Pollack1, M Pollak, L Rochon
1Department of Obstetrics and Gynecology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Canada.
Background:
Maternal malignancy may complicate as many as one in 1000 pregnancies. Rarely, the tumor may metastasize to the products of conception. We here describe a case of medulloblastoma metastatic to the placenta.
Case:
A 21-year-old woman who had previously undergone resection of a posterior fossa medulloblastoma was admitted at 20 weeks' gestation complaining of low back pain. Investigation revealed medulloblastoma metastatic to the bone marrow. The pregnancy was prolonged to 29 weeks' gestation, at which time she was delivered by cesarean. The postoperative course was complicated by coagulopathy, massive bleeding, and pneumonia leading to death. Autopsy showed medulloblastoma metastatic to the bone marrow and placenta.
Conclusion:
Primary intracranial neoplasms may metastasize to the products of conception. The dramatic course of the disease in this patient may suggest that medulloblastoma is responsive to hormonal therapy.