Case report and literature review: antenatal diagnosis of a fetal anaplastic astrocytoma

Abstract

Objectives

To describe the ultrasonographic appearance of congenital anaplastic astrocytoma, so as to provide diagnostic clues for it. An updated review of the literature was also carried out.

Results

There was a case of fetal anaplastic astrocytoma detected by ultrasound at 37 + 1 weeks of gestation. It showed that a hypoechoic mass was located in the left hemisphere with a relatively clear margin and subtle color flows. Prenatal magnetic resonance imaging (MRI) which was taken subsequently confirmed the result of ultrasound. Intratumoral hemorrhage was observed in later follow-up and further confirmed by histological examination. The fetus was delivered vaginally at 39 + 6 weeks. The infant died 2 h after delivery due to respiration failure. The histological examination confirmed an anaplastic astrocytoma.

Conclusions

Congenital anaplastic astrocytoma commonly detected by ultrasound has a relatively better perinatal prognosis, especially compared with glioblastoma. Prenatal ultrasonography diagnosis accurately is of critical importance. The anaplastic astrocytoma should be considered in cases in which fetal images reveal a heterogeneous echogenic mass in the brain, especially in the presence of intratumoral hemorrhage, subtle color flow, and relatively clear margin.

Keywords:

• Fetus
• intracranial neoplasms
• fetal anaplastic astrocytoma
• prenatal imaging
• ultrasonography

Ethical approval

The authors have no ethical conflicts to disclose. The patient and his family gave their informed consent to publish details and images of the case. This report was approved by our Institutional Review Board.

Disclosure statement

No potential conflict of interest was reported by the author(s)

Data availability statement

All the clinical, ultrasonographic, and radiological information pertinent to the patient described in this research are fully available in the description of the cases in the Case Reports section of the article.

Additional information

Funding

This study was financially supported by the National Natural Science Foundation of China [81600669], the Natural Science Foundation of Fujian Province, China [2016J01646], the Science and Technology Foundation of Xiamen, China [3502Z20164004], and Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou Medical College [XJM1803].