GLIAL CELL TUMORS

Wakai and associates (1) found 19 astrocytomas (9.5%) and 73 teratomas (63.5%) in a review of 200 reported cases.

ULTRASOUND

• Echogenic mass occupying most of the hemisphere resulting in contralateral ship of the falx (4).
• Macrocephaly. Found in 62% of cases in one series (1).
• Hemorrhage. Reported as high (14%) (1).
• Polyhydramnios may be present (2).
• Cardiac failure and fetal hydrops has been reported (3) in a massive intracranial teratoma due to intratumoral arteriovenous shunting.

DIFFERENTIAL DIAGNOSIS

Differentiation of tumor, hemorrhage, infarction and infection is not always possible antenatally. The difficulty may arise due to the vascular nature of the tumor or hemorrhage within the tumor (4). MR scanning is often unsuccessful in differentiating.

REFERENCES

1. Wakai S, Arai T, Nagai M. Congenital brain tumors. Surg Neurol 1984;21:597-609.
2. Shawker TH, Schwartz RM. Ultrasound appearance of a malignant brain tumor. J Clin Ultrasound 1983;11:35-36.
3. Scherer DM, Abramowicz JS, Eggers PC et.al. Prenatal ultrasonic diagnosis of intracranial teratoma and massive cardiomegaly with associated high-output cardiac failure. Am J Obstet Gynecol 1993;168:97-99.
4. Heckel S, Favre R, Gasser B, Christmann D. Prenatal diagnosis of congenital astrocytoma: a case report and literature review. Ultrasound Obstet Gynecol 1995;5:63-66.