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Imaging of fetal brain tumors

  • Fetal imaging
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A Correction to this article was published on 12 January 2021

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Abstract

Congenital brain tumors, defined as those diagnosed prenatally or within the first 2 months of age, represent less than 2% of pediatric brain tumors. Their location, prevalence and pathophysiology differ from those of tumors that develop later in life. Imaging plays a crucial role in diagnosis, tumor characterization and treatment planning. The most common lesions diagnosed in utero are teratomas, followed by gliomas, choroid plexus papillomas and craniopharyngiomas. In this review, we summarize the pathogenesis, diagnosis, management and prognosis of the most frequent fetal brain tumors.

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  • 12 January 2021

    A Correction to this paper has been published: <ExternalRef><RefSource>https://doi.org/10.1007/s00247-020-04777-z</RefSource><RefTarget Address="10.1007/s00247-020-04777-z" TargetType="DOI"/></ExternalRef>

References

  1. Milani HJ, Araujo Júnior E, Cavalheiro S et al (2015) Fetal brain tumors: prenatal diagnosis by ultrasound and magnetic resonance imaging. World J Radiol 7:17–21

    Article  PubMed  PubMed Central  Google Scholar 

  2. Uysal A, Oztekin O, Oztekin D, Polat M (2005) Prenatal diagnosis of a fetal intracranial tumor. Arch Gynecol Obstet 272:87–89

    Article  PubMed  Google Scholar 

  3. Schlembach D, Bornemann A, Rupprecht T, Beinder E (1999) Fetal intracranial tumors detected by ultrasound: a report of two cases and review of the literature. Ultrasound Obstet Gynecol 14:407–418

    Article  CAS  PubMed  Google Scholar 

  4. Cassart M, Bosson N, Garel C et al (2008) Fetal intracranial tumors: a review of 27 cases. Eur Radiol 18:2060–2066

    Article  CAS  PubMed  Google Scholar 

  5. Severino M, Schwartz ES, Thurnher MM et al (2010) Congenital tumors of the central nervous system. Neuroradiology 52:531–548

    Article  PubMed  Google Scholar 

  6. Isaacs H (2002) I. Perinatal brain tumors: a review of 250 cases. Pediatr Neurol 27:249–261

    Article  PubMed  Google Scholar 

  7. Nozaki M, Ohnishi A, Fujimaki T et al (2006) Congenital gemistocytic astrocytoma in a fetus. Childs Nerv Syst 22:168–171

    Article  PubMed  Google Scholar 

  8. Woodward PJ, Sohaey R, Kennedy A, Koeller KK (2005) From the archives of the AFIP: a comprehensive review of fetal tumors with pathologic correlation. Radiographics 25:215–242

    Article  PubMed  Google Scholar 

  9. Isaacs H (2002) II. Perinatal brain tumors: a review of 250 cases. Pediatr Neurol 27:333–342

    Article  PubMed  Google Scholar 

  10. Buetow PC, Smirniotopoulos JG, Done S (1990) Congenital brain tumors: a review of 45 cases. AJNR Am J Neuroradiol 11:793–799

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Venkatesh I, Kumar S, Mishra S (2015) Anaplastic ependymoma: a rare brain tumor in a neonate. J Clin Neonatol 4:265–267

    Google Scholar 

  12. Rickert CH, Göcke H, Paulus W (2002) Fetal ependymoma associated with Down’s syndrome. Acta Neuropathol 103:78–81

    Article  PubMed  Google Scholar 

  13. Ermis B, Aydemir C, Taspinar O et al (2006) Congenital medulloblastoma. Arch Dis Child Fetal Neonatal Ed 91:F373

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Korostyshevskaya AM, Savelov AA, Papusha LI et al (2018) Congenital medulloblastoma: fetal and postnatal longitudinal observation with quantitative MRI. Clin Imaging 52:172–176

    Article  PubMed  Google Scholar 

  15. Diguet A, Laquerrière A, Eurin D et al (2002) Fetal capillary haemangioblastoma: an exceptional tumour. A review of the literature. Prenat Diagn 22:979–983

    Article  PubMed  Google Scholar 

  16. Madsen C, Schroder HD (1993) Congenital intracranial meningioma. APMIS 101:923–925

    Article  CAS  PubMed  Google Scholar 

  17. Shekdar K, Feygin T (2011) Fetal neuroimaging. Neuroimaging Clin N Am 21:677–703

    Article  PubMed  Google Scholar 

  18. Korostyshevskaya AM, Prihod’ko IY, Savelov AA, Yarnykh VL (2019) Direct comparison between apparent diffusion coefficient and macromolecular proton fraction as quantitative biomarkers of the human fetal brain maturation. J Magn Reson Imaging 50:52–61

    Article  PubMed  PubMed Central  Google Scholar 

  19. Yarnykh VL (2012) Fast macromolecular proton fraction mapping from a single off-resonance magnetization transfer measurement. Magn Reson Med 68:166–178

    Article  CAS  PubMed  Google Scholar 

  20. Luks FI, Deprest JA (1993) Endoscopic fetal surgery: a new alternative? Eur J Obstet Gynecol Reprod Biol 52:1–3

    Article  CAS  PubMed  Google Scholar 

  21. Takayasu H, Kitano Y, Kuroda T et al (2010) Successful management of a large fetal mediastinal teratoma complicated by hydrops fetalis. J Pediatr Surg 45:e21–e24

    Article  PubMed  Google Scholar 

  22. Merchant AM, Hedrick HL, Johnson MP et al (2005) Management of fetal mediastinal teratoma. J Pediatr Surg 40:228–231

    Article  PubMed  Google Scholar 

  23. Rychik J, Khalek N, Gaynor JW et al (2016) Fetal intrapericardial teratoma: natural history and management including successful in utero surgery. Am J Obstet Gynecol 215:780.e1–780.e7

  24. Langer JC, Harrison MR, Schmidt KG et al (1989) Fetal hydrops and death from sacrococcygeal teratoma: rationale for fetal surgery. Am J Obstet Gynecol 160:1145–1150

    Article  CAS  PubMed  Google Scholar 

  25. Birnholz JC, Frigoletto FD (1981) Antenatal treatment of hydrocephalus. N Engl J Med 304:1021–1023

    Article  CAS  PubMed  Google Scholar 

  26. Bruner JP, Davis G, Tulipan N (2006) Intrauterine shunt for obstructive hydrocephalus — still not ready. Fetal Diagn Ther 21:532–539

    Article  PubMed  Google Scholar 

  27. Hodges R, De Catte L, Devlieger R et al (2018) Antenatal diagnosis: current status for paediatric surgeons. In: Losty PD, Flake AW, Rintala RJ et al (eds) Rickham’s neonatal surgery. Springer, London, pp 63–103

    Chapter  Google Scholar 

  28. Washburne JF, Magann EF, Chauhan SP et al (1995) Massive congenital intracranial teratoma with skull rupture at delivery. Am J Obstet Gynecol 173:226–228

    Article  CAS  PubMed  Google Scholar 

  29. Bolat F, Kayaselcuk F, Tarim E et al (2008) Congenital intracranial teratoma with massive macrocephaly and skull rupture. Fetal Diagn Ther 23:1–4

    Article  PubMed  Google Scholar 

  30. Alagappan A, Shattuck KE, Rowe T, Hawkins H (1998) Massive intracranial immature teratoma with extracranial extension into oral cavity, nose, and neck. Fetal Diagn Ther 13:321–324

    Article  CAS  PubMed  Google Scholar 

  31. Hirsigk L, Rajderkar D (2016) Fetal intracranial neoplasm — not always a teratoma! J Radiol Imaging 1:14–17

    Article  Google Scholar 

  32. Mathias CR, Rizvi C (2019) The diagnostic conundrum of maternal mirror syndrome progressing to pre-eclampsia — a case report. Case Rep Womens Health 23:e00122

    Article  PubMed  PubMed Central  Google Scholar 

  33. Braun T, Brauer M, Fuchs I et al (2010) Mirror syndrome: a systematic review of fetal associated conditions, maternal presentation and perinatal outcome. Fetal Diagn Ther 27:191–203

    Article  PubMed  Google Scholar 

  34. Isaacs H (2009) Fetal brain tumors: a review of 154 cases. Am J Perinatol 26:453–466

    Article  PubMed  Google Scholar 

  35. Isaacs H (2013) Brain tumors. In: Tumors of the fetus and infant. Springer, Berlin, pp 163–195

    Chapter  Google Scholar 

  36. Rickert CH (1999) Neuropathology and prognosis of foetal brain tumours. Acta Neuropathol 98:567–576

    Article  CAS  PubMed  Google Scholar 

  37. Rickert CH, Probst-Cousin S, Louwen F et al (1997) Congenital immature teratoma of the fetal brain. Childs Nerv Syst 13:556–559

    Article  CAS  PubMed  Google Scholar 

  38. Kurishima C, Wada M, Sakai M et al (2012) Congenital brain tumor: fetal case of congenital germ cell intracranial tumor. Pediatr Int 54:282–285

    Article  PubMed  Google Scholar 

  39. Köken G, Yilmazer M, Sahin FK et al (2008) Prenatal diagnosis of a fetal intracranial immature teratoma. Fetal Diagn Ther 24:368–371

    Article  PubMed  Google Scholar 

  40. O’Grady J, Kobayter L, Kaliaperumal C, O’Sullivan M (2012) 'Teeth in the brain' — a case of giant intracranial mature cystic teratoma. BMJ case rep 2012:bcr0320126130

  41. Peiró JL, Sbragia L, Scorletti F et al (2016) Management of fetal teratomas. Pediatr Surg Int 32:635–647

    Article  PubMed  Google Scholar 

  42. Kamil D, Tepelmann J, Berg C et al (2008) Spectrum and outcome of prenatally diagnosed fetal tumors. Ultrasound Obstet Gynecol 31:296–302

    Article  CAS  PubMed  Google Scholar 

  43. Cavalheiro S, Moron AF, Hisaba W et al (2003) Fetal brain tumors. Childs Nerv Syst 19:529–536

    Article  PubMed  Google Scholar 

  44. Heckel S, Favre R, Gasser B, Christmann D (1995) Prenatal diagnosis of a congenital astrocytoma: a case report and literature review. Ultrasound Obstet Gynecol 5:63–66

    Article  CAS  PubMed  Google Scholar 

  45. Isaacs H (2016) Perinatal (fetal and neonatal) astrocytoma: a review. Childs Nerv Syst 32:2085–2096

    Article  PubMed  PubMed Central  Google Scholar 

  46. Gilani A, Donson A, Whiteway S et al (2019) HGG-26. Targetable molecular alterations in congenital glioblastoma. Neuro Oncol 21:ii92

    Article  PubMed Central  Google Scholar 

  47. Patay Z (2016) New concepts in the imaging of pediatric brain tumors: the revival of age-old real estate principles. Curr Radiol Rep 4:32

    Article  Google Scholar 

  48. Brat DJ, Shehata BM, Castellano-Sanchez AA et al (2007) Congenital glioblastoma: a clinicopathologic and genetic analysis. Brain Pathol 17:276–281

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Macy ME, Birks DK, Barton VN et al (2012) Clinical and molecular characteristics of congenital glioblastoma. Neuro Oncol 14:931–941

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Isaacs H (2009) Perinatal (fetal and neonatal) tuberous sclerosis: a review. Am J Perinatol 26:755–760

    Article  PubMed  Google Scholar 

  51. Bader RS, Chitayat D, Kelly E et al (2003) Fetal rhabdomyoma: prenatal diagnosis, clinical outcome, and incidence of associated tuberous sclerosis complex. J Pediatr 143:620–624

    Article  PubMed  Google Scholar 

  52. Shah N (2018) Prenatal diagnosis of choroid plexus cyst: what next? J Obstet Gynaecol India 68:366–368

    Article  PubMed  Google Scholar 

  53. Cheng P-J, Shaw S-W, Soong Y-K (2006) Association of fetal choroid plexus cysts with Trisomy 18 in a population previously screened by nuchal translucency thickness measurement. J Soc Gynecol Investig 13:280–284

    Article  PubMed  Google Scholar 

  54. DiPietro JA, Cristofalo EA, Voegtline KM, Crino J (2011) Isolated prenatal choroid plexus cysts do not affect child development. Prenat Diagn 31:745–749

    Article  PubMed  PubMed Central  Google Scholar 

  55. Hopkins B, Sutton VR, Lewis RA et al (2008) Neuroimaging aspects of Aicardi syndrome. Am J Med Genet A 146A:2871–2878

    Article  PubMed  PubMed Central  Google Scholar 

  56. Tabori U, Shlien A, Baskin B et al (2010) TP53 alterations determine clinical subgroups and survival of patients with choroid plexus tumors. J Clin Oncol 28:1995–2001

    Article  CAS  PubMed  Google Scholar 

  57. Liu AK, Hankinson T, Wolff JEA (2018) Choroid plexus tumors. In: Radiation oncology for pediatric CNS tumors. Springer International, Cham, pp 353–363

    Chapter  Google Scholar 

  58. Parmar HA, Pruthi S, Ibrahim M, Gandhi D (2011) Imaging of congenital brain tumors. Semin Ultrasound CT MR 32:578–589

    Article  PubMed  Google Scholar 

  59. Pencalet P, Sainte-Rose C, Lellouch-Tubiana A et al (1998) Papillomas and carcinomas of the choroid plexus in children. J Neurosurg 88:521–528

    Article  CAS  PubMed  Google Scholar 

  60. Louis DN, Perry A, Reifenberger G et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820

    Article  PubMed  Google Scholar 

  61. Juraschka K, Taylor MD (2019) Medulloblastoma in the age of molecular subgroups: a review. J Neurosurg Pediatr 24:353–363

    Article  PubMed  Google Scholar 

  62. Sosa-Olavarría A, Díaz-Guerrero L, Reigoza A et al (2001) Fetal craniopharyngioma: early prenatal diagnosis. J Ultrasound Med 20:803–806

    Article  PubMed  Google Scholar 

  63. Kostadinov S, Hanley CL, Lertsburapa T et al (2014) Fetal craniopharyngioma: management, postmortem diagnosis, and literature review of an intracranial tumor detected in utero. Pediatr Dev Pathol 17:409–412

    Article  PubMed  Google Scholar 

  64. Jurkiewicz E, Bekiesińska-Figatowska M, Duczkowski M et al (2010) Antenatal diagnosis of the congenital craniopharyngioma. Polish J Radiol 75:98–102

    Google Scholar 

  65. Joó JG, Rigó J, Sápi Z, Timár B (2009) Foetal craniopharyngioma diagnosed by prenatal ultrasonography and confirmed by histopathological examination. Prenat Diagn 29:160–163

    Article  PubMed  Google Scholar 

  66. do Prado Aguiar U, Araujo JLV, Veiga JCE et al (2013) Congenital giant craniopharyngioma. Childs Nerv Syst 29:153–157

  67. Kuo JS, Casey SO, Thompson L, Truwit CL (1999) Pallister–Hall syndrome: clinical and MR features. AJNR Am J Neuroradiol 20:1839–1841

    CAS  PubMed  PubMed Central  Google Scholar 

  68. Li MH, Eberhard M, Mudd P et al (2015) Total colonic aganglionosis and imperforate anus in a severely affected infant with Pallister–Hall syndrome. Am J Med Genet A 167A:617–620

    Article  PubMed  CAS  Google Scholar 

  69. Barkovich AJ, Peacock W (1998) Sublobar dysplasia: a new malformation of cortical development. Neurology 50:1383–1387

    Article  CAS  PubMed  Google Scholar 

  70. Yilmaz N, Unal O, Kiymaz N et al (2006) Intracranial lipomas — a clinical study. Clin Neurol Neurosurg 108:363–368

    Article  PubMed  Google Scholar 

  71. Truwit CL, Barkovich AJ (1990) Pathogenesis of intracranial lipoma: an MR study in 42 patients. AJR Am J Roentgenol 155:855–864

    Article  CAS  PubMed  Google Scholar 

  72. Prieto LJ, Ruiz Y, Pérez R, De León LJ (2019) Prenatal diagnosis of pericallosal lipoma: systematic review. Eur J Paediatr Neurol 23:764–782

    Article  Google Scholar 

  73. Demaerel P, Van De Gaer P, Wilms G, Baert AL (1996) Interhemispheric lipoma with variable callosal dysgenesis: relationship between embryology, morphology, and symptomatology. Eur Radiol 6:904–909

    Article  CAS  PubMed  Google Scholar 

  74. Thankamony A, Harlow FH, Ponnampalam J, Clarke P (2007) Congenital brain tumour mimicking fetal intracranial haemorrhage. J Obstet Gynaecol 27:314–317

    Article  CAS  PubMed  Google Scholar 

  75. Emamian SA, Bulas DI, Vezina GL et al (2002) Fetal MRI evaluation of an intracranial mass: in utero evolution of hemorrhage. Pediatr Radiol 32:593–597

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Phoenix Children’s Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA

    Patricia Cornejo, Jennifer Vaughn, Mittun Patel, Dianna M. E. Bardo, Jeffrey Miller & Luis F. Goncalves

  2. Department of Neuroradiology, Barrows Neurological Institute, Phoenix, AZ, USA

    Patricia Cornejo, Jennifer Vaughn, Dianna M. E. Bardo & Jeffrey Miller

  3. Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA

    Patricia Cornejo, Jennifer Vaughn, Mittun Patel, Dianna M. E. Bardo, Jeffrey Miller & Luis F. Goncalves

  4. Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA

    Patricia Cornejo, Dianna M. E. Bardo & Jeffrey Miller

  5. Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA

    Patricia Cornejo, Jennifer Vaughn, Mittun Patel, Dianna M. E. Bardo, Jeffrey Miller & Luis F. Goncalves

  6. Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Tamara Feygin

  7. Department of Radiology, UT Southwestern, Dallas, TX, USA

    Cory M. Pfeifer

  8. International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation

    Alexandra Korostyshevska

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  1. Patricia Cornejo
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Cornejo, P., Feygin, T., Vaughn, J. et al. Imaging of fetal brain tumors. Pediatr Radiol 50, 1959–1973 (2020). https://doi.org/10.1007/s00247-020-04777-z

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