Ali Al-Ibrahim MFM Fellow

G1P0 of Japanese descent, 35+5 weeks of gestation

First seen at the low risk clinics Healthy, no comorbidities

Married, partner of Chinese descent

Hepatits B negative, VDRL negative, Rubella immune,

Blood group A Rh +ve. No smoking, no alcohol, no radiation exposure Prenatal vitamins and Diclectin throughout pregnancy

 At 11+6, NT 1.2
IPS negative, adjusted risk of T21 = 1:1730 Anatomy ultrasound at 19 weeks normal

Routine ultrasound done at 34+5 on March 27, 2012

In Summary
G1P0, 35+5
Infra-tentorial mass (tumor) with obstructive

hydrocephalus Normal BPD and HC

MRI on March

th, 29

2012

Congenital Intracranial Tumors Differential Diagnosis and Outcome

 Brain tumors occur less often in the first year of life

than in the older child and adolescent The peak age incidence in children is between 5 and 8 years Central nervous system neoplasms are the leading solid tumor in children and adolescents and are surpassed only by leukemia and lymphoma in frequency

 During the perinatal period brain tumors are

diagnosed less often than teratomas, neuroblastoma, and leukemia. However they cause over 10% of the deaths due to neoplasms in this age period Two thirds of brain tumors in the fetus and infant occur above the tentorium, the reverse is true for the older child. Some brain tumors occur in association with certain renal tumors in infants and children, for example, cerebral primitive neuroectodermal tumor (PNET) and Wilms tumor and rhabdoid tumor

 Clin Neuropathol. 2001 Sep-Oct;20(5):181-9. Neonatal tumors of the CNS: a report of 9 cases and a review. Ortega-Aznar A, Romero-Vidal FJ, de la Torre J, Castellvi J, Nogues P

Abstract Neonatal central nervous system (CNS) tumors are an uncommon and histologically heterogeneous group of neoplasms with different clinical and biological features from those arising in childhood. We report 9 cases in which a diagnosis of CNS tumor was confirmed by biopsy or autopsy during the years 1982-1997 in the Vall d'Hebrn Children's Hospital, Barcelona. Two cases were fetal tumors detected by fetal sonography, 3 patients were symptomatic in the first days after birth and 4 patients presented initial clinical signs in the first weeks or months of life. Eight lesions were supratentorial and 1 was located in the spinal cord. According to histologic types, there were 2 glioneuronal tumors, 1 anaplastic astrocytoma, 1 choroid plexus carcinoma, 1 immature teratoma, 1 craniopharyngioma, 1 hemangioblastoma, 1 astroblastoma and 1 hemangioendothelioma. Extensive review of the literature indicates that our cases of hemangioblastoma, astroblastoma and hemangioendothelioma are exceptional and one more of the very rare and isolated previously published cases.