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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Dilemmas in primary spinal glioblastoma management during pregnancy
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Vol. 67. Issue 6.
Pages 347-350 (June - July 2020)
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Vol. 67. Issue 6.
Pages 347-350 (June - July 2020)
Case report
Dilemmas in primary spinal glioblastoma management during pregnancy
Dilemas en el manejo de glioblastoma espinal primario durante el embarazo
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3
I. Aguiar
Corresponding author
inesaguiarpereira@hotmail.com

Corresponding author.
, E. Ferreira, R. Pontes, A. Panzina, M. Paiva, A. Milheiro
Departamento de Anestesiología, Centro Hospitalario Vila Nova de Gaia/Espinho, E.P.E, Vila Nova de Gaia, Portugal
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Abstract

Primary spinal glioblastoma (GBM) is a clinically rare entity with rapid progression and a dismal outcome despite aggressive treatment. In a pregnant woman, this malignancy is particularly dramatic because the potential benefits to the mother offered by standard GBM treatment must be balanced against the risks to the foetus. There is little guidance in the literature on how to manage pregnant patients with malignant neuraxial tumours and, to the authors’ knowledge, no reports have been published so far regarding this specific neoplasm in such population. This case report describes the management of a pregnant patient with a previously undiagnosed and rapidly progressive intramedullary GBM submitted to an elective caesarean delivery to allow subsequent onset of oncological treatment. Dilemmas faced by anaesthetists are discussed in hope to provide guidance for future decisions and optimize outcomes.

Keywords:
Spinal glioblastoma
Pregnancy
Anaesthesia
Caesarean delivery
Resumen

El glioblastoma espinal primario (GBM) es una entidad clínicamente rara, con progresión rápida y resultado inevitable, a pesar de su manejo intensivo. En una mujer embarazada, esta neoplasia es particularmente grave, ya que los beneficios potenciales para la madre que ofrece el tratamiento estándar para GBM deben sopesarse frente a los riesgos para el feto. Existen pocas directrices en la literatura sobre cómo manejar a las pacientes embarazadas con tumores neuroaxiales malignos y, en opinión de los autores, no se han publicado informes hasta la fecha sobre este neoplasma específico en dicha población. Este caso clínico describe el manejo de una paciente embarazada con GBM no diagnosticado previamente, con rápida progresión intramedular, a la que se realizó cesárea electiva para permitir el inicio de tratamiento oncológico. Debatimos los dilemas a los que se enfrentan los anestesistas, con esperanza de aportar directrices ante las futuras decisiones y de optimizar los resultados.

Palabras clave:
Glioblastoma espinal
Embarazo
Anestesia
Parto por cesárea

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