Prenatal diagnosis of intracranial tumors and the difficulties in prognostication: A report of three cases

Abstract

Prenatal diagnosis of intracranial tumors generally implies a poor prognosis. We present three such cases, where prognostication was difficult. We attempted to correlate our prenatal counseling with postnatal follow-up/postabortal diagnosis. In the first case, tumor was diagnosed at 37 weeks. Ultrasound and fetal/neonatal MRI suggested a malignant intraventricular tumor. Anticipating guarded prognosis, parents refused neurosurgical intervention. At 1 year, child has normal neurodevelopment. Further magnetic resonance imagings (MRIs) show tumor shrinkage, pointing to a benign tumor. In case two, a choroid plexus tumor was diagnosed at midtrimester anomaly scan. Since it was difficult to rule out a malignant tumor, pregnancy was terminated. However, MRI, autopsy, and histopathology confirmed a choroid plexus papilloma, which is known to have good prognosis. In case three, prenatal MRI showed features of neurological involvement in tuberous sclerosis. However child has no neurological manifestations at 1 year of age. Hence, prognostication of prenatally diagnosed brain tumors remains a challenge.