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Background: Neurofibromatosis is a rare pregnancy complication that can present with rapidly enlarging masses that have malignant potential.Case: A 19-year-old primagravid woman with a known history of neurofibromatosis presented in her first trimester with pulmonary complaints. A malignant mediastinal mass was diagnosed and resected, with additional treatment options declined. In less than 3 months, the patient presented with a recurrent mass that resulted in fatal airway compromise during the same gestation.Conclusion: Neurofibromatosis type 1 with malignant peripheral nerve sheath tumors complicating pregnancy requires an experienced, multidisciplinary team of care offering an aggressive evaluation to rule out malignant transformation or recurrence when there is any change in clinical status of a patient, as this may signal a potentially fatal change in the lesion. [ABSTRACT FROM AUTHOR]

Objective: To assess whether functional maternal or fetal genotypes along well-characterized metabolic pathways (ie, CYP1A1, GSTT1, and CYP2A6) may account for varying associations with adverse outcomes among pregnant women who smoke.Methods: DNA samples from 502 smokers and their conceptuses, alongside women in a control group, were genotyped for known functional allelic variants of CYP1A1 (Ile462Val AA>AG/GG), GSTT1(del), and CYP2A6 (Lys160His T>A). Modification of the association between smoking and outcome by genotype was evaluated. Outcomes included birth weight, pregnancy loss, preterm birth, small for gestational age, and a composite outcome composed of the latter four components plus abruption.Results: No interaction between maternal or fetal genotype of any of the polymorphisms and smoking could be demonstrated. In contrast, the association of smoking with gestational age-adjusted birth weight (birth weight ratio) was modified by fetal GSTT1 genotype (P for interaction=.02). Fetuses with GSTT1(del) had a mean birth weight reduction among smokers of 262 g (P=.01), whereas in fetuses without the GSTT1(del) the effect of tobacco exposure was nonsignificant (mean reduction 87 g, P=.16). After adjusting for confounding, results were similar.Conclusion: Fetal GSTT1 deletion significantly and specifically modifies the effect of smoking on gestational age-corrected birth weight. [ABSTRACT FROM AUTHOR]