수질아세포종 환자에서의 성공적 임신과 분만 1예
A CASE REPORT ON SUCCESSFUL PREGNANCY AND DELIVERY IN A MEDULLOBLASTOMA PATIENT
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수질아세포종(medulloblastoma)은 성인에게 매우 드문 질환이다. 치료는 수술적 제거와 방사선 조사가 병행되며, 두개척수 조사 후 시상하부-뇌하수체축과 자궁, 난소의 손상으로 불임을 유발할 수 있어 임신 가능성이 매우 낮다. 저자들은 수질아세포종으로 뇌수술 및 전뇌척추 방사선 조사 치료 후에도 자연 임신하였던 환자를 경험하였다. 산모는 임신 26주에 두통과 허리통증의 발생을 동반한 수질아세포종의 재발 및 척추 전이를 진단 받았으나 임신을 지속하기 위해 보존적 치료를 유지하던 중 반복되는 전신 경련 증상으로 임신 29주 3일에제왕절개 분만하였고, 신생아의 경과가 양호하여 건강하게 퇴원하였다.
Abstract
Medulloblastomas are rare neoplasms in adults. Medulloblastomas are treated by surgical removal of the tumor followed by radiotherapy. Because craniospinal irradiation can damage the hypothalamic-pituitary axis, uterus, and ovaries, and consequently result in infertility, the probability of pregnancy is quite low. We managed a patient who had undergone resection of a posterior fossa medulloblastoma and received craniospinal irradiation, who conceived spontaneously during follow-up. She was diagnosed with a recurrent medulloblastoma with metastasis to the spine accompanied by headaches and back pain at 26 weeks gestation. Conservative treatment measures were utilized in an effort to prolong the pregnancy. She was delivered by cesarean section due to recurrent seizure activity at 29 weeks plus 3 days gestation. The neonate made favorable progress and was discharged in good condition.
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