Meningioma In Pregnancy

Meningioma In Pregnancy

I Gusti Putu Victor Widnyana¹, Rahmat Andi Hartanto²

1. Resident of General Surgery, GMU Faculty of Medicine/RSUP Dr Sardjito Yogyakarta

2. Consultant Neurosurgeon, GMU Faculty of Medicine/RSUP Dr Sardjito Yogyakarta

 Abstract

Introduction

Meningioma is one of the most frequent types of brain tumors in adults. It remains an issue that can’t be resolved by the neurologists, neurosurgeons, and oncologists. Meningioma is 15-20% of brain tumors and 10-15% of all meningiomas considered as malignant tumors. The incidence of meningiomas in women is higher than men. Tumor growth is stimulated by female sex hormones that lead to rapid growth in pregnancy or breast cancer.

Clinical symptoms such as nausea, vomiting, and convulsions sometimes are misdiagnosed as hyperemesis gravidarum in early pregnancy or preeclampsia in late pregnancy age. Abnormal funduscopy examination, vision disturbances, focal seizures, lateralization of neurological deficits are supporting the diagnosis of intracranial masses and then further tests should be performed using a CT scan or MRI for diagnosis.

Case Description

Female, 34 years old, G5P4A0, 30 weeks of pregnancy with impairment of consciousness (GCS E3V5M4). Since seven years prior admission, patients have often felt an intermittent headache. Headache felt worse in the past year. Ten months before admission, the patient perform a CT scan of the head and was diagnosed as meningioma. But the patient refused to do the surgical removal of the tumor at the time and chose to do alternative medicine. Perceived symptoms of patients continued to deteriorate up to 15 days before admission the patient had weakness in both lower extremities. The patient was not able to walk alone and should be assisted by others. Three days before admission the patient fell because it had total weakness on both lower extremity. The patient was then taken to one hospital in Purworejo but the situation continued to deteriorate until the occurrence of impairment of consciousness then eventually refer the patient to the dr. Sardjito hospital, Yogyakarta. Then the patients underwent surgical removal of the tumor as well as termination of pregnancy. Anatomical pathology results showed a transitional meningioma grade I.

Key Words : meningioma, pregnancy