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EP09.08: Fetal intracranial teratoma: a role for prenatal imaging to facilitate obstetric management
Author(s) -
Dickinson J.E.,
White S.W.,
Fender L.,
Berry B.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19915
Subject(s) - medicine , fetus , obstetrics , macrocephaly , sacrococcygeal teratoma , pregnancy , ventriculomegaly , fetal head , hydrocephalus , gestation , surgery , pediatrics , genetics , biology
A 32-year-old primigravida at 18 weeks’ gestation, the antenatal ultrasonography indicated a communication between the fourth ventricle and the cisterna magna. The upper portion of vermis was normal sized. There was ’keyhole sign’ of cerebellar vermis without mega-cisterna magna. Fetal magnetic resonance imaging (MRI) at 21 weeks’ gestation showed upward rotated vermis with mild hypoplastic inferior vermis. Brainstem-Vermis (BV) angle and Brainstem-Tentorium (BT) angle were 23 and 42 degree. The size of vermis was 15mm on sonography at 24 weeks’ gestation, appropriate for gestational age. Follow up MRI at 24 weeks’ gestation revealed improvement in upward rotation of vermis and development of vermis. Therefore, we highly suspected BPC rather than DWM. At 1 month after delivery, brain MRI of baby revealed a mild widening of cerebellopontine angle without retrocerebellar cistern widening and relatively intact cerebellar vermis. Differentiating BPC from DWM and vermian hypoplasia in early gestation still remain challenges. Our report may provide informative data for differential diagnosis of posterior fossa abnormalities and MRI can be helpful for diagnosis.