Case Report Pediatr Neurosurg 2001;35:39–42 Maternal Lung Adenocarcinoma Metastatic to the Scalp of a Fetus Case Report Terri L. Harpold a Michael Y. Wang a J. Gordon McComb a Hector L. Monforte c Michael L. Levy a John F. Reinisch b Divisions of a Neurosurgery and b Plastic Surgery, c Department of Pathology, Childrens Hospital of Los Angeles and the Department of Neurological Surgery, University of Southern California/Keck School of Medicine, Los Angeles, Calif., USA Received: March 16, 2001 Accepted: April 27, 2001 J. Gordon McComb, MD Childrens Hospital of Los Angeles 1300 N. Vermont Avenue, #906 Los Angeles, CA 90027 (USA) Tel. +1 323 663 8128, Fax +1 323 668 1870 ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2001 S. Karger AG, Basel 1016–2291/01/0351–0039$17.50/0 Accessible online at: www.karger.com/journals/pne Key Words Metastatic adenocarcinoma W Fetal metastasis W Maternal malignancy Abstract Maternal malignancy metastatic to the fetus is a rare event, with most neoplasms being either melanocytic or hematopoietic in origin. This report is the first known case of a maternal lung adenocarcinoma metastatic to a fetus. At 2 months of age, this male infant developed multiple scalp masses that were locally resected but rap- idly recurred. The histology of the scalp lesions and that of a biopsy of the mother’s tumor were both adenocarci- noma and were remarkably similar in appearance. In situ hybridization of tumor cells from this male infant found many large nuclei with XX signals indicating that the tumor was of maternal origin. This patient is alive, well and free of malignancy 5 years after a wide local resec- tion of the scalp and skin grafting. Copyright © 2001 S. Karger AG, Basel Introduction Since the placenta acts as a selective barrier between mother and fetus, maternal metastatic tumors gaining access to the fetal membranes or the fetus are extremely rare, only 54 such cases having been reported [1]. The majority of these malignancies have been either melano- cytic or hematopoietic in origin. We report the first case of maternal lung adenocarcinoma metastatic to the fetus. Case Report The 45-year-old mother of the patient under consideration devel- oped a persistent cough during the 6th month of her pregnancy. A chest X-ray at that point was normal. She had never smoked. She subsequently developed a neck mass that was biopsied and on histologic examination was found to be an adenocarcinoma. A CT scan showed widespread lung disease with evidence of metastases to the liver and adrenals. She received no chemo- or radiation therapy. The patient was delivered at 32 weeks of gestation because of the mother’s rapidly deteriorating condition. The placenta was not histo- logically examined but there was no gross evidence of disease noted. The mother died 4 days after giving birth. The family history was only notable for the mother’s mother having died of breast cancer. The patient was delivered uneventfully and weighed 1.95 kg at birth. He initially required assisted ventilation for the first 5 days of life. He also developed mild hyperbilirubinemia that responded rap- idly to phototherapy. He was well enough to be discharged home by