Medical and ethical challenges in the case of a prenatally undiagnosed massive congenital brain tumor

M. Olischar, T. Stavroudis, J. K. Karp, W. E. Kaufmann, C. Theda

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Fetal and neonatal brain tumors are rare. Prenatal ultrasound aids early tumor detection. Nonetheless, we encountered a preterm neonate born at 32 weeks gestation with a massive supratentorial glioma, which was undetected on ultrasound at 19-6/7 weeks gestation. The patient presented at birth with unanticipated massive macrocephaly. Resuscitation and stabilization were difficult, but the medical team felt that futility of care was not established and opted to transfer the baby to an academic center for further imaging and specialist consultations. Diagnosis of an extensive, inoperable tumor was confirmed and support withdrawn. Postmortem histologic examination and immunohistochemical stains identified the majority of tumor cells as glial in origin. This case report illustrates well how a severe and potentially fatal anomaly, which remained undetected prenatally, presented the medical team and family with multiple medical, ethical and emotional challenges at birth; decisions regarding futility of care in the neonatal transport setting are difficult.

    Original languageEnglish (US)
    Pages (from-to)773-775
    Number of pages3
    JournalJournal of Perinatology
    Volume35
    Issue number9
    DOIs
    StatePublished - Sep 28 2015

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Obstetrics and Gynecology

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