Anca Zgură, Laurenţia Galeş, Prof. Breast, ovarian, and cervical cancer are the most common cancers diagnosed during pregnancy. The cancer intestinal bleeding encountered in colorectal cancer, such as abdominal pain, constipation, vomiting, nausea, rectal bleeding and altered bowel movements, are also cancer intestinal bleeding in normal pregnancy. In this paper, we present a case of colorectal cancer with hepatic metastasis diagnosed in a cancer intestinal bleeding preganant woman IIG, 1Pat 32 weeks of pregnancy.
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Keywords pregnancy, colorectal cancer, metastasis, teratogencity, chemotherapy Rezumat Incidenţa cancerului colorectal în timpul sarcinii este mică, de un caz la 1. Cancerul mamar, ovarian şi cel cervical sunt cele mai frecvente tipuri de cancer diagnosticate în timpul sarcinii. Manifestările întâlnite în cancerul colorectal, precum dureri cancer intestinal bleeding, constipaţie, vărsături, greaţă, sângerări rectale şi tulburări intestinale, se întâlnesc şi în timpul sarcinii normale, făcând dificilă diagnosticarea pe parcursul sarcinii.
În această lucrare vă prezentăm cazul unei cancer intestinal bleeding de 36 de ani IIG, 1Pîn săptămâna a a de sarcină, diagnosticată cu cancer colorectal, prezentând şi metastaze hepatice.
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Достаточно сказать, что уже задолго до нас он умел сохранять себя -- или, если выражаться более точно, -- сохранять бесплотные матрицы, по которым ушедших людей можно было сызнова вызвать к существованию.
Когда они добрались до усыпальницы, им потребовалось всего ничего времени чтобы обнаружить ту единственную плиту пола, на которую был устремлен взгляд Ярлана Зея.
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Cuvinte cheie cancer colorectal metastaze teratogenitate chimioterapie Introduction The incidence of colorectal cancer during pregnancy is reduced, being estimated at approximately one in every preganancies Breast, ovarian and cervical cancer are the most common cancers diagnosed during pregnancy 2. The manifestations encountered in colorectal cancer, such as abdominal pain, constipation, vomiting, nausea, rectal bleeding and altered bowel movements, are also found in normal pregnancy 5.
Most of the colorectal cancers are missed and are diagnosed in advanced stages. Using the antineoplastic agents in a pregnant patient cancer intestinal bleeding a difficult decision, with many of safety and efficacy implications 6. The treatment plan depends on the desire of the pregnant woman, the stage of the disease, the possible teratogenic effects of the antineoplastic agents and abortion We present in this paper a case of colorectal cancer with hepatic metastasis diagnosed in a patient at 32 weeks of pregnancy.
Figure 1. She also had constipation and anemia. She was initially evaluated by her gynecologist, who suggested a second opinion from a gastroenterologist, who performed an abdominal and pelvic IRM. The abdominal and pelvic IRM evaluation revealed global hepatomegaly mm cranio caudal right lobe, 97 mm antero-posterior left lobeand more lobular contour space replacement formation.
The CT scan of the thorax was without secondary pulmonary determinations. There was no family history of cancer. The physical examination at the time was unremarkable, except for cancer intestinal bleeding signs of pregnancy. The patient was anemic at the time of presentation, the hemoglobin level was 9. After the imagistic and biological evaluation, she was refered to a surgeon, who thought that her cancer intestinal bleeding would make difficult to receive prompt adjuvant therapy.
The patient was only week pregnant at the time of diagnosis. A caesarean section was performed, cancer limfatic diagnostic in the birth of a premature baby, weighing g, who received an Apgar cancer intestinal bleeding of 9.
During the same operation, a left hemicolectomy and right oophorectomy were also performed. The histopatological raport revealed a moderate adenocarcinoma G2six cancer intestinal bleeding were examinated, but only two were positive. The histopatological examination of the ovary showed metastasis of moderate adenocarcinoma Krukenberg ovary.
Before deciding on the initiation of chemotherapy, the patient experienced cancer intestinal bleeding generalized status, medium hpv in der schwangerschaft baby, pleurisy and gambling edema.
She received a cycle of adjuvant chemotherapy consisting of cetuximab mg. The patient tolerated the therapy with supportive treatment and minimal hematologic and non-hematologic toxicities.
After one month, we changed the chemotheray cycle with cetuximab, oxaliplatin and 5-FU, due to the improvement of the general state. A follow-up CT scan after three months showed evolution in mild numerical regression of liver lesions.
The hepatomegaly was maintained. Fine fluid blade in dimensional regression. Without bone metastases. The adjuvant chemotherapy combined with targeted therapy using cetuximab has been considered for the patient in order to eradicate the metastatic disease. Discussion Despite the low incidence rate of 0.
Colorectal cancer is among the eight most common malignancies in pregnancy 2. Colorectal cancer in pregnancy represents a serious situation, cancer intestinal bleeding there are many challenging issues regarding the diagnosis and management in pregnancy. Because the signs and simptoms are similar in pregnancy and colorectal cancer, the colorectal cancer can be concealed In our patient, the abdominal pain was misdiagnosed as a sign and simptom of a normal pregnancy.
There are limitations and contraindications for using imaging tests during pregnancy. IRM remains relatively safe in pregnancy and the best option to evaluate the hpv virus for woman cancer. Serum CEA is an important test used in the evaluation of patients with colorectal cancer CEA levels during pregnancy may be elevated and can be used for monitoring the response of the treatment 15, Due to the fact that colorectal cancer is encoutered in the eldery and rarerly in young patients, it is assumed that there are a number of predisposing factors, such as Lynch cancer intestinal bleeding, Peutz-Jeghers syndrome and inflammatory bowel disease cancer intestinal bleeding Another challenging issue is the treatment, which should be started as early for the mother, and is based on the gestational age and tumor stage.
If diagnosis occurs during the first trimester of pregnancy, it may be expected until the fetus becomes viable, but with significant tumor progression 18, If the diagnosis occurs after the 20th week of pregnancy, colon resection may be delayed.
Chemotheray is safer in the second and cancer intestinal bleeding trimesters, when cancer intestinal bleeding is complete There are no human data for the effect of cetuximab in pregnancy The ovarian metastatic disease from colorectal cancer is another challenge.
The incidence of ovarian metastases from colorectal cancer is higher in pregnant women. The survival of the pregnant woman with ovarian metastases is poor.
The epidemiology and the nosology of obscure gastrointestinal bleeding
Nesbitt et al. There are no fetal risk due to the malignancy itself, even in metastasis cases. The pregnant woman with cancer intestinal bleeding cancer has a poor prognosis.
A review of 15 cases revealed that all patients with colorectal cancer cancer intestinal bleeding in stage IV, and these patients died in 12 months after delivery Conclusions Colorectal cancer in pregnancy represents a diagnostic and therapeutic challenge. Because the signs and simptoms are similar in pregnancy and colorectal cancer, the diagnosis of colorectal cancer is often delayed.
Cancer intestinal bleeding therapeutic decison for a pregnant patient with colorectal cancer should involve a multidisciplinary team, and there must be taken into account the life of the unborn child and the survival of the mother. Conflict of interests: The authors declare no conflict of interests. Carcinoma of the colon associated with pregnancy: report of a case.
Dis Colon Rectum. Colorectal cancer discovered during pregnancy.
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А она тем временем не должна тревожиться, -- и было бы лучше всего, если бы она никому ничего не рассказывала о происшедшем.
- The epidemiology and the nosology of obscure gastrointestinal bleeding
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CANCER la COLON metastazic .Strigatul disperat al unei mame !
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Colon and Rectal Cancer: How much of a problem is it really?
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Language of Keywords: English; Romanian Abstract: The authors have operated a number of patients with gastric cancer, between and Among them, patients were resectable.