Dr Sabrina Hossain1, Associate Professor Karin Lust2, Dr Penny Wolski3, Dr Catherine Bettington4, Dr Claire Muller5
1Royal Brisbane and Women's Hospital, Herston, Australia, 2Royal Brisbane and Women's Hospital, Herston, Australia, 3Royal Brisbane and Women's Hospital, Herston, Australia, 4Royal Brisbane and Women's Hospital, Herston, Australia, 5Royal Brisbane and Women's Hospital, Herston, Australia
Biography:
Dr Sabrina Hossain is currently a junior house officer graduating from Griffith University. She did her internship at Royal Brisbane and Women's Hospital and is currently working at Gold Coast University Hospital. She is aiming to apply to BPT this year with a special interest in Obsetric Medicine.
Abstract:
Background: Meningiomas are a type of intracranial tumour that are rarely diagnosed during pregnancy. They are predominantly benign and their clinical features can often be mistaken for other common pathologies causing neurological symptoms such as venous sinus thrombosis or eclampsia.
Case report: We present two case reports describing patients with cavernous sinus meningioma associated with pregnancy. The first patient was a 33-year-old female who was initially diagnosed with cavernous sinus thrombosis and presented with sixth cranial nerve palsy one week post-partum. The second patient was a 40 year old female who presented with trigeminal neuropathy in her third trimester. In both cases, the symptoms regressed during the post-partum period. A conservative management approach was undertaken with an ongoing plan for regular surveillance of the meningioma.
Conclusion: The clinical management of meningioma during pregnancy is largely dependent on the location and presence of mass effect such as raised intracranial pressure or focal neurological symptoms due to compression of adjacent structures. Delaying intervention until the post-partum period is preferred to minimise both foetal and maternal risks. In addition, spontaneous improvement of symptoms is expected following pregnancy. Meningiomas have been found to express progesterone receptors and due to the reduction in serum progesterone post-partum, regression of the tumour size is noted. Given the high-risk anatomical location of cavernous sinus meningioma, surgery is avoided if possible, with a regular clinical review and radiological surveillance of the tumour.
Keywords
meningioma, pregnancy, post-partum
References
Pettersson-Segerlind J, Mathiesen T, Elmi-Terander A, Edström E, Talbäck M, Feychting M, Tettamanti G. The risk of developing a meningioma during and after pregnancy. Sci Rep. 2021 Apr 28;11(1):9153. doi: 10.1038/s41598-021-88742-2. PMID: 33911184; PMCID: PMC8080659.
Pettersson-Segerlind J, Mathiesen T, Elmi-Terander A, Edström E, Talbäck M, Feychting M, Tettamanti G. The risk of developing a meningioma during and after pregnancy. Sci Rep. 2021 Apr 28;11(1):9153. doi: 10.1038/s41598-021-88742-2. PMID: 33911184; PMCID: PMC8080659.
Nidamanuri P, Shastin D, Nannapaneni R. Cavernous sinus meningioma presenting as third nerve palsy in pregnancy. BMJ Case Rep. 2018 May 12;2018:bcr2017223152. doi: 10.1136/bcr-2017-223152. PMID: 29754131; PMCID: PMC5965808.