Primary brain tumours manifesting during pregnancy: presentation of six cases and a review of the literature.

We review six cases of primary brain tumours with an initial manifestation of symptoms during pregnancy. Three patients presented with epileptic seizures, two with progressive motor disturbance, and one with visual disturbance. Three patients were diagnosed as harbouring brain tumours at 20-25 weeks of pregnancy, while the remaining three were diagnosed at 36-38 weeks of pregnancy. The tumours consisted of three cerebral gliomas of various degrees of malignancy and one case each of cerebellar medulloblastoma, pituitary adenoma and convexity meningioma. Three patients safely underwent surgical removal of the tumours at 24-31 weeks of pregnancy without any adverse effects on the foetus and two received postoperative radiation therapy. In the remaining three patients, who ranged from 36-38 weeks of pregnancy at diagnosis, neurosurgical intervention was deferred until after delivery. Some of the problems in the management of brain tumours during pregnancy are discussed.