MENG-07 Multidisciplinary strategy for management of convexity meningioma in pregnant woman in Benin: a case report and literature review

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Abstract The overall incidence rate of primary brain and other CNS tumor was higher in females than males and meningiomas was significantly predominant in females representing over two times cases compared to males. It has been reported trends of increasing in terms of cases and also growth of meningiomas during pregnancy, suggesting a relationship between non-malignant meningiomas and hormonal changes. However, the management of meningioma in pregnancy women remained under debate and controverse. We discuss the management of a convexity meningioma in a 35-year-old pregnant woman of 24 weeks gestation with good outcomes for the patient and her pregnancy who has been dropped in our hospital after consulting many facilities around her. On neurological examination, the patient was found drowsy with Glasgow Coma Scale of 13 – 14/15 and had diplopia and facial weakness consisting of cranial nerve’s VI and VII deficit, left side hemiparesis of 3/5 in motor and sensitive testing with spasticity. Brain MRI demonstrated a very large homogeneously enhancing mass arising from meninges with dural tail in the right frontal lobe extending posteriorly to the motor cortex and an associated mass effect on surrounding neural elements. Then, surgical planning involved a multidisciplinary team consisting with neurosurgeon, obstetrician, anesthesiologist and physical therapist. All aspects have been considered and evaluated to minimize the risk of perioperative morbidity and mortality and to identify key points that will need to be addressed perioperatively. The patient remained in the decision-making process. On a three-months follow-up, all symptoms improved except diplopia, brain MRI demonstrated no residual tumor and repetitive ultrasound was unremarkable for pregnancy. Three months postoperatively, she gave birth through vaginal delivery to a beautiful strong baby girl weighted 2.800 kg and Apgar 9/9/10.

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