Case Reports in Obstetrics and Gynecology (Jan 2020)

Colon Adenocarcinoma during Pregnancy: A Case Report and Review of the Literature

  • Paolo Petruzzelli,
  • Roberto Zizzo,
  • Elisabetta Tavassoli,
  • Miriam Sutera,
  • Michela Chiadò Fiorio Tin,
  • Luca Petruzzelli,
  • Mariachiara Benedetto,
  • Maria Rosa D’Anna,
  • Paolo De Paolis,
  • Guido Menato

DOI
https://doi.org/10.1155/2020/8894722
Journal volume & issue
Vol. 2020

Abstract

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Colorectal cancer (CRC) during pregnancy presents an estimated incidence of 1 : 13,000, and it is associated with diagnostic and therapeutic challenges. Here, we present the case of a 38-year-old woman, 25 weeks and 5 days pregnant, who was transferred to our Obstetrics and Gynecology Department from a local hospital with the diagnosis of intestinal obstruction. Magnetic Resonance Imaging (MRI) showed marked distension with hydroaerial levels of the enterocolic loops upstream of a concentric parietal thickening of the descending colon, stenosing, extended longitudinally for about 4 cm. An exploratory laparotomy was performed with resection of the colon splenic flexure and mechanical end-terminal anastomosis. Histological examination of the operating piece highlighted the presence of moderately differentiated (G2) colon adenocarcinoma (stage pT3N1b). The operation was followed by a single course of oxaliplatin and 5-FU plus leukovorin. The patient had a vaginal delivery at 37 weeks+2 days of gestational age, following induction of labor and giving birth to a male infant whose weight was 2670 gr with apgar 9/9. We underline the pivotal role of attention to unspecific symptoms, early diagnosis, and active treatment in changing the clinical course of CRC.