Case Report: Pregnancy in a patient with recurrent glioblastoma

We report the case of a woman with relapsed glioblastoma multiforme (GBM) who recently gave birth. She announced her pregnancy shortly after the sixth cycle of a dense regimen of temozolomide, prescribed for treating the first recurrence of glioblastoma. Three years ago, in April 2008, she had undergone gross total resection of a glioblastoma multiforme in the postcentral region of the right hemisphere and had subsequently received treatment according to the actual standard therapy consisting of radiotherapy up to 60 Gy with concomitant and adjuvant temozolomide. The complete amount of temozolomide given before this pregnancy was 20.9 mg/m 2. Nevertheless, she delivered a 1890 g child by caesarean section in the 32/6 week of pregnancy. The child showed no anomalies and is developing normally under close surveillance by paediatricians.

[1]  S. Kelly,et al.  Successful pregnancy and delivery after concomitant temozolomide and radiotherapy treatment of glioblastoma multiforme. , 2012, Clinical oncology (Royal College of Radiologists (Great Britain)).

[2]  C. Marosi,et al.  Pilot study on sex hormone levels and fertility in women with malignant gliomas , 2012, Journal of Neuro-Oncology.

[3]  C. Marosi,et al.  Temozolomide Dosing Regimens for Glioma Patients , 2012, Current Neurology and Neuroscience Reports.

[4]  João Cláudio Emmerich,et al.  Management strategy for brain tumour diagnosed during pregnancy , 2011, British journal of neurosurgery.

[5]  C. Poirot,et al.  Chimiothérapie à gonadotoxicité inconnue et préservation de la fertilité : exemple du témozolomide ☆ , 2010 .

[6]  H. Duffau,et al.  Pregnancy increases the growth rates of world health organization grade II gliomas , 2009, Annals of neurology.

[7]  H. Duffau,et al.  Influence of pregnancy in the behavior of diffuse gliomas: clinical cases of a French glioma study group , 2009, Journal of Neurology.

[8]  M. Sermer,et al.  Obstetric outcomes of women with intracranial neoplasms , 2009, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[9]  D. Blumenthal,et al.  Management of malignant gliomas during pregnancy , 2008, Cancer.

[10]  T. Salokorpi,et al.  Obstetric and perinatal outcome and preliminary results of development of children born after in vitro maturation of oocytes. , 2006, Human reproduction.

[11]  P. Audra,et al.  Prise en charge des gliomes malins découverts au cours d’une grossesse , 2006 .

[12]  Martin J. van den Bent,et al.  Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. , 2005, The New England journal of medicine.

[13]  D. Garry,et al.  Glioblastoma multiforme in pregnancy , 2005, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[14]  N. Twyman,et al.  Radiotherapy for glioma during pregnancy: fetal dose estimates, risk assessment and clinical management. , 2004, Clinical oncology (Royal College of Radiologists (Great Britain)).

[15]  M. Stark,et al.  The Misgav Ladach method for cesarean section, method description , 1999, Acta obstetricia et gynecologica Scandinavica.

[16]  E. Darj,et al.  The Misgav Ladach method for cesarean section compared to the Pfannenstiel method , 1999, Acta obstetricia et gynecologica Scandinavica.

[17]  Satoshi O. Suzuki,et al.  Primary brain tumours manifesting during pregnancy: presentation of six cases and a review of the literature , 1996, Journal of Clinical Neuroscience.

[18]  D. Topliss.  Optic‐nerve glioma and pregnancy , 1989, The Medical journal of Australia.

[19]  W. Kamphorst,et al.  Pregnancy-related primary brain and spinal tumors. , 1987, Archives of neurology.

[20]  M. Sanson,et al.  [Unknown gonadotoxicity chemotherapy and preservation of fertility: example of Temozolomide]. , 2010, Gynecologie, obstetrique & fertilite.

[21]  F. Ducray,et al.  [Management of malignant gliomas diagnosed during pregnancy]. , 2006, Revue neurologique.