Locally advanced colorectal cancer in pregnancy

Czech version

Authors: I. Němcová ^1,2; P. Gloserová ¹; J. Kubát ³; G. Hensel ^1,2; M. Košťál ^1,2
Authors‘ workplace: Porodnicko-gynekologická klinika Pardubické nemocnice, Nemocnice Pardubického kraje, přednosta doc. MUDr. M. Košťál, CSc. ¹; Fakulta zdravotnických studií Univerzity Pardubice, děkan prof. MUDr. J. Fusek, DrSc. ²; Interní klinika Pardubické nemocnice, Nemocnice Pardubického kraje, přednosta MUDr. P. Vojtíšek, CSc. ³
Published in: Ceska Gynekol 2019; 84(3): 208-211
Category: Case Report

Overview

Objective: To highlight the issue of diagnostics and treatment management in colorectal cancer of pregnant women.

Design: Case report.

Setting: Department of Obstetrics and Gynaecology, Pardubice Hospital.

Case report: We present a case of a 24-year-old secundigravida, diagnosed as colorectal cancer in week 34 of pregnancy, manifesting as a diarrhoea and a stomach ache. The diagnosis was made in an advanced stage due to underestimation of clinical symptoms.

Conclusion: The diagnosis of the colorectal cancer in pregnancy can be difficult because the presenting symptoms are easily attributable to pregnancy. Therefore the advanced disease is diagnosed more frequently in pregnant patients than in the general population. Colorectal cancer should be managed by multidisciplinary team with regard to gestation.

Keywords:

pregnancy – colorectal cancer – diarrhoea in pregnancy

Sources

1. Arbman, G., Nilsson, E., Störgren-Fordell, V., Sjödahl, R. A short diagnostic delay is more important for rectal cancer than for colonic cancer. Eur J Surg, 1996, 162(11), p. 899–904.

2. Aytac, E., Ozuner, G., Isik, O., et al. Management of colorectal neoplasia during pregnancy and in the postpartum period. World J Gastrointest Oncol, 2016, 8(7), p. 550–554.

3. Bernstein, MA., Madoff, RD., Caushaj, PF. Colon and rectal cancer in pregnancy. Dis Colon Rectum, 1993, 36, p. 172–178.

4. Cappell, MS. Colon cancer during pregnancy. The gastroenterologist‘s perspective. Gastroenterol Clin North Am, 1998, 27, p. 225–256.

5. Češka, R., et al. Interna. 1. vyd. Praha: Triton, 2010, s. 396–415.

6. de Haan, J., Verheecke, M., Van Calstere, K., et al. Oncological management and obstetric and neonatac outcomes for woman diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients. Lancet Oncol, 2018, 19, p. 337–346.

7. Ehrmann, J. Diferenciální diagnostika průjmu a možnosti léčby. Inter Med praxi, 2011, 13(4), s. 167–170.

8. Halaška, MJ., Rob, L., et al. Onkologická onemocnění během těhotenství. Praha: Mladá fronta, 2015, s. 14–19, 44–53, 65–73, 193–195.

9. Jones, A., Powlov, MR. Colorectal cancer presenting with constipation during pregnancy. Cureus, 2017, 9(4), e1190.

10. Kocián, P., de Haan, J., Cardonick, EH., et al. Management and outcome of colorectal cancer during pregnancy: report of 41 cases. Acta Cirurgica Belgica, 2018. DOI: 10.1080/00015458.2018.1493821

11. Kopáčková, M., Beránek, P., Bydžovská, I., et al. Non-Hodgkinův B-lymfom ovarií s nepříznivou prognózou – náhodný nález při císařském řezu. Čes Gynek, 2018, 83, s. 45–49.

12. Lolis, ED., Likoudis, P., Voiniadis, P., et al. Synchronous rectal and colon cancer caused by familial polyposis coli during pregnancy. J Obstet Gynaecol Res, 2007, 33, p. 199–202.

13. Makoshi, Z., Perrott, C., Al-Khatani, K., Al-Mohaisen, F. Chemotherapeutic treatment of colorectal cancer in pregnancy: case report. J Med Case Reports, 2015, 9, p. 140.

14. Martin, DD. Review of radiation therapy in the pregnant cancer patient. Clin Obstet Gynecol, 2011, 54, p. 591–601.

15. Poulsen, MLM., Bisgaard, ML. MUTYH associated polyposis (MAP). Current Genomics, 2008, 9, p. 420–435.

16. Rogers, JE., Dasari A., Eng, C. The treatment of colorectal cancer during pregnancy: Cytotoxic chemotherapy and targeted therapy challenges. Oncologist, 2016, 21, p. 563–570.

17. Salani, R., Billingsley, CC., Crafton, SM. Cancer and pregnancy: an overview for obstetricians and gynecologist. Am J Obstet Gynecol, 2014, 211, p. 7–14.

18. Sarandakou, A., Protonotarious, E., Rizos, D. Tumor markers in biological fluids associated with pregnancy. Crit Rev Clin Lab Sci, 2007, 44, p. 151–178.

19. Tawadros, PS., Paquette, IM., Hanly, AM., et al. Adenocarcinoma of the rectum in patients under age 40 is increasing: impact of signet-ring cell histology. Dis Colon Rectum, 2015, 58, p. 474–478.