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In adults, it represents about 1% of cancer found in the central nervous system. In adult medulloblastoma, only one third of cases occur in women and even less in pregnant women.This case describes a 34-year-old pregnant woman who presented to the emergency department with the syncope, which was found to be secondary to a medulloblastoma.
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To report two rare cases of medulloblastoma in pregnant patients and a review of the literature. Report of patients diagnosed with medulloblastoma during their pregnancies, who were treated with surgery and adjuvant therapy. We also reviewed other cases reported in the literature and the association made with hormonal receptors.
Medulloblastoma is the most common central nervous system malignancy in children; however, it is significantly less common among adults, particularly elderly individuals. We herein report an unusual case of a 72-year-old woman who presented with progressive dizziness.
Medulloblastoma is the most common central nervous system (CNS) malignancy in children; however, it is extremely uncommon among adults, comprising only 0.4–1% of CNS neoplasms in adults. Medulloblastoma is located in the cerebellar hemispheres and exhibits a male predominance in the adult population.
Medulloblastoma ( MB) is the most common malignant pediatric brain tumor and a leading cause of cancer-related death, accounting for 10-20% of brain tumors in children, but are observed infrequently in adults, accounting for an estimated 1% of primary central nervous system (CNS) tumors in adults [1], [2]. Approximately 70% of patients are diagnosed before the age of 20. There is a slight increase in incidence between the ages of 20 to 24 years, and the disease is rare after the fourth decade, consistent with its embryonal origin [3], [4]. Medulloblastoma, a primitive neuroectodermal tumor, is now considered to originate from not only cerebellar external granular layer precursors, but also ventricular zone and dorsal brainstem neuronal progenitors. On a molecular level, MB are heterogeneous and can be divided into four distinct subgroups with distinct cellular origins, genetics, clinical behavior, and patient outcomes [5], [6], [7]. Patients with MB classically present with clinical signs and symptoms of increased intracranial pressure due to cerebrospinal fluid flow obstruction or cerebellar dysfunction. As the disease progresses and the tumor infiltrates the brainstem, cranial nerves dysfunction becomes more common [8]. It has been described that the cerebellar granule cells can respond to the stimulation of its estrogen receptors, and therefore the association that the high levels of this hormone observed during pregnancy can be a contributing factor for the appearance and growth of MB in predisposed women [9]. In the following article we present 2 cases of medulloblastoma diagnosed in pregnant women, as well as a discussion of the pathogenic mechanisms and management in the context of pregnancy.
Brain tumors in coincidence with pregnancy are unusual, and the incidence of medulloblastoma in pregnancy is still rarer. We found 8 cases of medulloblastomas diagnosed during pregnancy. Reports suggest that hormonal changes and increases in the levels of growth factors and angiogenic factors during pregnancy influence the rate of growth of brain tumors (not only medulloblastomas but also meningiomas or glial tumors).
Medulloblastoma is a malignant brain tumor (WHO grade IV) that arise from stem cells located in the sub ependymal matrix or the external granular layer of the cerebellum [10]. The clinical course of this tumor is often rapid, with prominent symptoms of increased intracranial pressure and cerebellar dysfunction. Tumors during pregnancy are not uncommon, but primary brain tumors in coincidence with pregnancy are unusual, and the incidence of medulloblastoma in pregnancy is still rarer [2], [11]. In a literature review, we found 8 cases of medulloblastomas diagnosed during pregnancy ( Table 1 ). Reports suggest that hormonal changes and increases in the levels of growth factors and angiogenic factors during pregnancy influence the rate of growth of brain tumors (not only medulloblastomas but also meningiomas or glial tumors) [9], [12], [13].