OC36.06: Just images: Case report of an intracranial teratoma presenting as disorganized cranial anatomy on routine 20‐week ultrasound
Bibliographic record
Abstract
Mrs. A.D. was a 30 year old G-4, P-3 presenting for routine anatomical ultrasound at 20 weeks' gestational age. The fetus was appropriately sized with normal anatomical survey apart from bizarre intracranial structures. The patient was referred to our tertiary care facility for further assessment and recommendations. Initial diagnosis of the findings was severe anoxic-hypoxic insult with brain matter destruction, or significant infection with resultant disorganized brain. Alternatively was primary brain disorder such as severe hydrocephalus, atypical holoprosencephaly, or intracranial tumor. Following discussion of options, the couple elected to proceed with the pregnancy and follow up with further investigations. Serology for viral infections (CMV, rubella, HSV and EBV), screen for alloimmune thrombocytopenia, and hypercoaguable screen were all negative. Karyotype showed 46,XX, and amniotic fluid PCR was negative for infection. MRI was performed to attempt to better characterize the lesion, and showed no recognizable brain tissue, cerebellum, or brain stem. No discrete tumor mass was seen and the impression was again a severe anoxic brain injury. Secondary diagnoses remained necrosis and degeneration due to severe intrauterine infection, or diffuse tumor. 2 weeks later the patient presented with dramatically increased symphysis fundus height, and brief scan confirmed massive polyhydramnios. Significant hydrocephalus was also apparent. Given the poor prognosis, early induction of labour organized for later that week. The patient presented 4 days later at 23.5 weeks with lack of fetal movement, and stillbirth was confirmed. Induction of labour was initiated with misoprostol leading to breech vaginal delivery. Significant dystocia was present, and cephalocentesis performed. Autopsy showed a large teratoma arising from the skull base and completely occluding blood flow to the normal brain, with resultant infarction and degeneration of surrounding cerebral tissue. http://www.interscience.wiley.com/jpages/0960-7692/suppmat/index.html This article contains supplementary material available via the Internet from the Journal http://www.interscience.wiley.com/jpages/0960-7692/suppmat/index.html Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".