Colorectal Cancer During Pregnancy – Case Report And Brief Review Of The Literature

Abstract: Malignancies in pregnant women are very rare with colorectal cancer being the eighth most commonly found. Colon cancer during the pregnancy is often diagnosed at an advanced stage because of its symptoms which are attributed to the pregnancy. This paper described a case of a 34-year-old female patient, 22 weeks pregnant, who was admitted to the Department of General and Transplantation Surgery due to deep venous thrombosis (DVT) and bleeding into the lower gastrointestinal (GI) tract. Endoscopy of the lower GI tract revealed an ulcerated polyp in the sigmoid colon. The histopathologic report showed infiltrated adenocarcinoma coli G2. The abdominal ultrasound scan (USS) and the chest X- ray detected hepatic and pulmonary metastases. After consideration, the tumor resection was postponed because it would not significantly improve the patient’s health condition and would endanger the fetus. The medical treatment plan was to wait until the 32nd-34th week of pregnancy and perform a simultaneous C-section, recto-sigmoid resection and hysterectomy. After intrauterine fetal death at 27 gestational week, computer tomography (CT) revealed disseminated metastases in the liver, lungs and peritoneum. The patient was referred to palliative chemotherapy. In conclusion, diagnostics and treatment of colon cancer during pregnancy is a challenge for the obstetrician and oncological team.

Authors:

Kinga Grzelak, Marta Bil, Magdalena Czerwińska, Anna Cencelewicz-Lesikow, Monika Bieniasz

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