8,109 results on '"Pregnancy Complications, Neoplastic"'
Search Results
2. Adverse obstetric outcomes in female survivors of adolescent and young adult cancers.
- Author
-
Huang Y and Wang H
- Subjects
- Humans, Female, Pregnancy, Adolescent, Young Adult, Adult, Pregnancy Outcome, Pregnancy Complications, Neoplastic, Cancer Survivors statistics & numerical data, Neoplasms
- Abstract
Competing Interests: We declare no competing interests.
- Published
- 2024
- Full Text
- View/download PDF
3. Adverse obstetric outcomes in female survivors of adolescent and young adult cancers.
- Author
-
Tang W, Liu T, and Lan X
- Subjects
- Humans, Female, Pregnancy, Adolescent, Young Adult, Adult, Pregnancy Outcome, Pregnancy Complications, Neoplastic, Cancer Survivors statistics & numerical data, Neoplasms
- Abstract
Competing Interests: We declare no competing interests.
- Published
- 2024
- Full Text
- View/download PDF
4. Ruptured Ovarian Mature Teratoma in a Pregnant Woman with Severe Chemical Peritonitis: A Case Report.
- Author
-
Fernandes GN, Thill K, Sharma V, and Igel C
- Subjects
- Humans, Female, Adult, Pregnancy, Rupture, Spontaneous, Laparoscopy, Diagnosis, Differential, Teratoma complications, Teratoma diagnosis, Peritonitis diagnosis, Peritonitis etiology, Ovarian Neoplasms diagnosis, Ovarian Neoplasms complications, Pregnancy Complications, Neoplastic
- Abstract
BACKGROUND Mature cystic teratomas (MCTs) account for about 25% of ovarian lesions. They are usually asymptomatic, but can complicate pregnancies if they lead to ovarian torsion or chemical peritonitis due to spontaneous rupture. CASE REPORT A 31-year-old woman who was gravida 4, para 1, aborta 1 at 26 weeks 0 days gestation presented with nonspecific, severe, acute-onset abdominal pain, which persisted despite conservative measures. Initial imaging showed a pelvic fluid collection and she was taken for a diagnostic laparoscopy, which showed purulent fluid in her pelvis. While the differential diagnosis included acute appendicitis and ruptured tubo-ovarian abscess, the source of the pain was determined to be a ruptured mature cystic teratoma. CONCLUSIONS A ruptured MCT is a reasonable addition to the differential diagnosis for pelvic pain in pregnancy. A pelvic washout during a diagnostic laparoscopy is an ideal way to manage the chemical peritonitis due to a spontaneously ruptured MCT.
- Published
- 2024
- Full Text
- View/download PDF
5. Giant renal angiomyolipomas with spontaneous hemorrhage associated with tuberous sclerosis complex during pregnancy.
- Author
-
Mao J, Wei K, Yang S, Wang C, and Hu L
- Subjects
- Humans, Female, Pregnancy, Adult, Angiomyolipoma complications, Angiomyolipoma diagnostic imaging, Tuberous Sclerosis complications, Kidney Neoplasms complications, Pregnancy Complications, Neoplastic, Hemorrhage etiology
- Published
- 2024
- Full Text
- View/download PDF
6. Shared immunosuppressive mechanism between pregnancy and cancer.
- Author
-
Gummlich L
- Subjects
- Humans, Pregnancy, Female, Immune Tolerance, Pregnancy Complications, Neoplastic, Neoplasms immunology
- Published
- 2024
- Full Text
- View/download PDF
7. Pregnancies complicated with functioning adrenal adenomas causing severe obstetric outcomes: a 20-year experience at a tertiary center.
- Author
-
Zhu C, Cai S, Zhong X, and Huang L
- Subjects
- Humans, Female, Pregnancy, Adult, Retrospective Studies, Adenoma complications, Adenoma surgery, Adrenalectomy, Adrenocortical Adenoma complications, Adrenocortical Adenoma surgery, Adrenocortical Adenoma pathology, Prognosis, Young Adult, Adrenal Gland Neoplasms complications, Adrenal Gland Neoplasms surgery, Pregnancy Complications, Neoplastic, Tertiary Care Centers, Pregnancy Outcome
- Abstract
Background: Functioning adrenal adenoma during pregnancy is rare, and the diagnosis is challenging owing to unspecific symptoms and restricted investigations. The obstetric outcomes of patients who undergo surgery during pregnancy or who receive only medical treatment are poorly described., Objective: The aim was to investigate the associations between functioning adrenal adenomas and obstetric outcomes., Methods: A retrospective study was performed in a tertiary center over 20 years. The clinical characteristics, management and obstetric outcomes of the diagnosed pregnant women were reviewed., Results: A total of 12 women were diagnosed with functioning adrenal adenomas during pregnancy from January 2002 to September 2022. Eight women had cortisol-secreting adrenal adenomas, two had excessive catecholamine secretion, and two had primary aldosteronism. The initial symptoms of adrenal adenoma during pregnancy included hypertension or preeclampsia, gestational diabetes mellitus or prepregnancy diabetes mellitus, hypokalemia and ecchymosis. Four women underwent adrenalectomy during pregnancy, while 8 women received only medical therapy. Preterm birth occurred in all patients who received medicine, whereas 1 patient who underwent surgery experienced preterm birth. Among the 8 women in the medical treatment group, 3 had neonates who died., Conclusions: Once hypertension, hyperglycemia and hypokalemia occur during the 1st or 2nd trimester, pregnant women with adrenal adenomas should be evaluated via laboratory and imaging examinations. The maternal and fetal outcomes were unpredictable owing to the severity of adrenal adenoma, particularly in patients who received only medical treatment. Adrenalectomy should be recommended during pregnancy., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
8. 妊娠合并卵巢肿瘤的诊疗进展 .
- Author
-
辛玉琦 and 王晓慧
- Abstract
Pregnancy associated with ovarian tumors (POT) is one of the most complications of pregnancy. With the application of ultrasound in prenatal examination, more and more POT has been diagnosed during pregnancy. POT is mostly a functional cyst that discovered by chance during pregnancy and resolved spontaneously. The incidence of malignant POT is 1%-6%, among which disgerminoma is the most common. Most of POT have no specific clinical symptoms, while a few of POT can rupture, twist and so on with acute abdomen. There are various clinical diagnosis methods. Ultrasound examination is usually the first choice for imaging examination. Tumor markers can help to assess the potential malignant risk. At present, there is no standardized diagnosis and treatment guideline of POT. Both maternal and fetal factors should be taken into consideration in treatment. Clinicians should make the individual plan for each POT patient according to her gestational week, tumor type, disease stage, etc. Due to the advantages of less bleeding and faster recovery, laparoscopic surgery is preferred. This article reviews the progress of POT diagnosis and treatment in order to provide reference for clinical work. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
9. Pregnancy and Cancer-Navigating Impossible Decisions.
- Author
-
Kachikis A and Eckert LO
- Subjects
- Female, Humans, Pregnancy, Neoplasms, Pregnancy Complications, Neoplastic
- Published
- 2024
- Full Text
- View/download PDF
10. Survival in pregnancy-associated breast cancer patients compared to non-pregnant controls.
- Author
-
Martín Cameán M, Jaunarena I, Sánchez-Méndez JI, Martín C, Boria F, Martín E, Spagnolo E, Zapardiel I, and Hernández Gutiérrez A
- Subjects
- Humans, Pregnancy, Female, Prognosis, Parturition, Breast Neoplasms pathology, Pregnancy Complications, Neoplastic, Azides, Propanolamines
- Abstract
Background: Pregnancy-associated breast cancer (PABC) is a rare entity whose prognosis has previously been studied and is subject to controversy., Methods: Survival of patients with PABC diagnosed between 2009 and 2021 with breast cancer during pregnancy or until 1 year after childbirth was compared with non-pregnant patients with breast cancer from the same period at La Paz University Hospital. Cox proportional hazards regression was used to compare disease-free (DFS) and overall (OS) survival between the groups, adjusting for grade and pathologic stage., Results: Among the 89 included patients with breast cancer, 34 were diagnosed during pregnancy, and 55 were not pregnant. The pregnant patients were more likely to have grade 3 tumors (61.3% vs 37%, p = 0.023) and an advanced stage (pathologic stage III-IV: 44.1% vs 17.6%, p = 0.008). Median follow-up was 47 months for the pregnant group and 46 months for the control group. After adjustments for tumor grade and pathologic stage, OS was comparable between the groups (HR 2.03; 95% CI 0.61 to 6.79; P = 0.25)., Conclusions: The outcome of women diagnosed with PABC is comparable to young non-pregnant controls. However, it should be taken into account that PABC has a more aggressive phenotype., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
11. Approaching cancer during pregnancy.
- Author
-
Varella L and Partridge AH
- Subjects
- Female, Humans, Pregnancy, Neoplasms genetics, Neoplasms therapy, Pregnancy Complications, Neoplastic
- Published
- 2024
- Full Text
- View/download PDF
12. Innovation in fetal surgery: Use of vascular plugs in placental chorioangioma with fetal hydrops
- Author
-
Magdalena Sanz Cortes, Hunter Bechtold, Athar M. Qureshi, Henri Justino, Jimmy Espinoza, Ahmed A. Nassr, Roopali Donepudi, Eumenia Castro, Betul Yilmaz Furtun, Nancy Ayres, Michael Belfort, and Alireza Shamshirsaz
- Subjects
Placenta Diseases ,Pregnancy ,Hydrops Fetalis ,Placenta ,Humans ,Obstetrics and Gynecology ,Female ,Hemangioma ,Pregnancy Complications, Neoplastic ,Ultrasonography, Prenatal ,Genetics (clinical) - Published
- 2022
13. Characterization and clinical management of abnormal cytology findings in pregnant women: a retrospective analysis
- Author
-
Rosa Freudenreich, Martin Weiss, Tobias Engler, Felix Neis, and Melanie Henes
- Subjects
Vaginal Smears ,Pregnancy ,Cesarean Section ,Colposcopy ,Humans ,Uterine Cervical Neoplasms ,Obstetrics and Gynecology ,Female ,Pregnant Women ,General Medicine ,Uterine Cervical Dysplasia ,Pregnancy Complications, Neoplastic ,Retrospective Studies - Abstract
Purpose The diagnosis of cervical intraepithelial neoplasia during pregnancy poses a great challenge to the treating clinician and the patient. According to the current guidelines, watchful waiting during pregnancy can be justified. Only in cases of invasion, immediate treatment may be indicated. However, few data are available on the management of cervical dysplasia during pregnancy. Further research is important for counselling affected women. Methods Data of pregnant patients with suspected cervical dysplasia who presented to the University Women’s Hospital Tübingen between 2008 and 2018 were evaluated retrospectively. Colposcopic, cytologic, and histologic assessment was performed for diagnosis. Data on remission, persistence and progression of disease based on histologic and cytologic assessment and the mode of delivery were correlated. Results 142 patients were enrolled. Cytology at first presentation was PAPIII (-p/-g) in 7.0%, PAPIIID (IIID1/IIID2) in 38.7%, PAPIVa (-p/-g) in 50.0%, PAPIVb (-p) in 2.8%, and PAPV (-p) in 1.4%. All cases with suspected invasion were recorded at the initial presentation. Complete histological or cytological remission was observed in 24.4%, partial remission in 10.4%, persistence in 56.3%, and progression in 8.9%. In two cases (1.5%) progression to squamous cell carcinoma occurred. Conclusions Watchful waiting for cervical intraepithelial neoplasia during pregnancy seems to be sufficient and oncologically safe. It is important to exclude invasion during pregnancy, to perform frequent colposcopic, cytologic and histologic examinations and to ensure a postpartum follow-up examination to initiate the treatment of high-grade lesions. Spontaneous delivery seems to be safe in patients with cervical dysplasia, Caesarean section is not indicated.
- Published
- 2022
14. Cancer and Pregnancy
- Author
-
Eytan R. Barnea, Eric Jauniaux, Peter E. Schwartz, Eytan R. Barnea, Eric Jauniaux, and Peter E. Schwartz
- Subjects
- Cancer in pregnancy, Pregnancy--Complications, Pregnancy Complications, Neoplastic
- Abstract
Cancer and Pregnancy covers the clinical challenges to diagnosing and treating malignancies in the pregnant patient; however, the book also shows how an understanding of the common features of both processes (rapid cell proliferation) may lead to novel anti-cancer treatment options. The book should be read by obstetricians and gynaecologists, clinical oncologists, reproduction specialists, and those involved in investigation of development, biology, toxicology, immunology, as well as cancer research.
- Published
- 2012
15. 妊娠合并宫颈癌患者继续妊娠的治疗方法研究进展.
- Author
-
邬艾佳 and 艾志宏
- Abstract
As the age of pregnancy grows, the rate of cervical cancer during pregnancy is increasing and the management of cervical cancer during pregnancy is also becoming more difficult in clinic. During treatment, safety of both pregnant women and offspring should be taken into account. Management of patients wishing to preserve of her pregnancy aim at fewer adverse effects on fetuses, less tumor progress and similar outcomes with non-pregnancy women with cervical cancer. Current options to treat pregnant patients with cervical cancer desired to preserve pregnancy contains expectant treatment, surgery and chemotherapy. Radical trachelectomy, simple trachelectomy and conization are common surgical methods and most common chemotherapy is based on platinum,with or without other agents. Commonly, patients with stage ⅠA1 cervical cancer are eligible for expectant treatment. Surgical treatment is option for patients with stage ⅠA2-ⅠB1 cervical cancer and neoadjuvant chemotherapy is used in patients with stage ⅠB1 or greater cervical cancer. Patients with lymph nodes metastasis should terminate pregnancy. We will make conclusions on the latest progression of pregnancy-preserving managements. [ABSTRACT FROM AUTHOR]
- Published
- 2019
16. Melanoma in pregnancy: Diagnosis and management in early-stage and advanced disease
- Author
-
Thomas J. Carter, Christina George, Catherine Harwood, and Paul Nathan
- Subjects
Cancer Research ,Skin Neoplasms ,Oncology ,Pregnancy ,Incidence ,Humans ,Female ,Melanoma ,Pregnancy Complications, Neoplastic - Abstract
Approximately one-third of women diagnosed with melanoma are of child-bearing age. The annual incidence of melanoma has risen steadily over the last 40 years, resulting in increasing numbers of women diagnosed with melanoma both during pregnancy, and post-partum. To date, there are no formal guidelines on the management of pregnancy associated melanoma (PAM), both early stage and metastatic. This article reviews the existing literature and provides a framework for the investigation and multidisciplinary management of PAM.
- Published
- 2022
17. Lymphoma during pregnancy in Japan: a multicenter retrospective cohort study
- Author
-
Chie Onishi, Momoko Nishikori, Kimikazu Yakushijin, Shingo Kurahashi, Hideyuki Nakazawa, Yasushi Takamatsu, Yoshinori Hashimoto, Hiro Tatetsu, null Yuichiro Nawa, Masahiro Yoshida, Tsutomu Kobayashi, Tatsuo Oyake, Shingo Yano, Aki Oride, and Ritsuro Suzuki
- Subjects
Adult ,Incidence ,Lymphoma, Non-Hodgkin ,Pneumonia, Pneumocystis ,Pregnancy Outcome ,Lymphadenopathy ,Hematology ,Hodgkin Disease ,Survival Rate ,Young Adult ,Japan ,Pregnancy ,Humans ,Female ,Pregnancy Complications, Infectious ,Pregnancy Complications, Neoplastic ,Follow-Up Studies ,Retrospective Studies - Abstract
This study was conducted to characterize lymphoma occurring during pregnancy and to investigate the outcomes of the patients and the fetuses.Clinical data were gathered retrospectively from 29 patients at 13 participating institutions, and data from 28 eligible patients were analyzed.Six (21%) patients had Hodgkin lymphoma (HL) and 22 (79%) patients had non-Hodgkin lymphoma (NHL). All patients with HL presented with lymphadenopathy, but 15 (68%) of the 22 patients with NHL presented with extranodal sites only. At the median follow-up period of 1325 (range 6-4461) days, the 5-year overall survival rate was 63% for patients with NHL and 100% for patients with HL. Three of the 13 patients who received chemotherapy during pregnancy (23%) developed Pneumocystis jiroveci pneumonia (PCP). There was 1 intrauterine fetal death, 1 spontaneous abortion in the first trimester, and 15 (54%) preterm births.This study showed a higher proportion of NHL than HL during pregnancy in Japan, which was inconsistent with the proportions observed in Western countries. The high incidence of maternal PCP and preterm birth suggested the need for improvements in our management of lymphoma during pregnancy.
- Published
- 2022
18. Pregnancy-associated plasma protein-A (PAPPA) promotes breast cancer progression
- Author
-
Jun Zhang, Yuan Zhang, Lanjiang Li, Yinghua Nian, Ying Chen, Ruoxia Shen, and Xiaoyan Ma
- Subjects
Epithelial-Mesenchymal Transition ,Bioengineering ,Breast Neoplasms ,Applied Microbiology and Biotechnology ,Mice ,Cell Movement ,Pregnancy ,Cell Line, Tumor ,Animals ,Humans ,Pregnancy-Associated Plasma Protein-A ,Neoplasm Metastasis ,Cell Proliferation ,mir-497-5p ,pappa ,mda-mb-231 ,General Medicine ,Up-Regulation ,Gene Expression Regulation, Neoplastic ,MicroRNAs ,Case-Control Studies ,mcf7 ,Disease Progression ,MCF-7 Cells ,Female ,Pregnancy Complications, Neoplastic ,pabc ,Neoplasm Transplantation ,TP248.13-248.65 ,Research Article ,Research Paper ,Biotechnology - Abstract
Breast cancer is the most common malignancy in females and poses a significant health threat to women. Pregnancy-associated plasma protein-A (PAPPA) is highly expressed in pregnancy-associated breast cancer (PABC) tissues. In this study, we investigated the functional role of PAPPA in regulating the malignant phenotype of breast cancer. We first examined the expression level of PAPPA in PABC tissue and breast cancer cell lines using quantitative real-time polymerase-chain reaction (qRT-PCR) and western blot. Next, the functional role of PAPPA in breast cancer cells was validated by overexpression and knockdown experiments. Cell counting kit-8 (CCK-8) proliferation assay, 5-ethynyl-2′-deoxyuridine (EdU) incorporation assay, wound healing and transwell invasion assay were used to examine cell proliferation, migration, and invasion ability. We further identified the microRNA target regulating PAPPA and studied its functional role. Finally, we examined the impact of PAPPA on the tumorigenesis and metastasis of breast cancer in mice model. Our study revealed that PAPPA was upregulated in PABC tissues and breast cancer cells. Overexpression of PAPPA promoted cell proliferation, motility, invasion, and epithelial–mesenchymal transition (EMT). We further identified miR-497-5p as a negative regulator of PAPPA, which suppressed cell proliferation, migration, invasion, and EMT in breast cancer cells. We also validated the oncogenic role of PAPPA in the mouse xenograft model. Collectively, our study suggests that PAPPA is an oncogenic protein highly expressed in PABC tissues and promotes breast cancer progression, which could serve as a novel therapeutic target for breast cancer.
- Published
- 2022
19. Giant fibroepithelial vulvar polyp in a pregnant woman
- Author
-
Lurdes Silva, Tatiana Gigante Gomes, Júlio Matias, and Carolina Smet
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Pregnancy Trimester, Third ,030105 genetics & heredity ,Vulva ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Polyps ,Neoplasms, Fibroepithelial ,Pregnancy ,medicine ,Fibroepithelial Polyp ,Humans ,Vulvar Polyp ,Vulvovaginal Region ,Unusual Presentation of More Common Disease/Injury ,Vulvar Neoplasms ,business.industry ,Obstetrics ,Cesarean Section ,First pregnancy ,Infant, Newborn ,General Medicine ,Bleed ,medicine.disease ,medicine.anatomical_structure ,Treatment Outcome ,Female ,Uterine Hemorrhage ,Elective caesarean section ,business ,Pregnancy Complications, Neoplastic ,030217 neurology & neurosurgery - Abstract
Fibroepithelial polyps are benign lesions that may appear in the vulvovaginal region. They usually occur in women of reproductive age and tend to grow up to 5 cm, but there are some rare cases in which they grow up to 20 cm. We report a case of a 22-year-old woman in the third trimester of her first pregnancy with spontaneous bleeding from a pedunculated mass measuring 15 cm in the widest diameter on the right side of the vulva. Features of this case are discussed as well as its implications, especially regarding the decision of labour. Due to the big size of the mass and its propensity to bleed, we decided to perform an elective caesarean section as well as its excision.
- Published
- 2023
20. Cancer Diagnoses Following Abnormal Noninvasive Prenatal Testing: A Case Series, Literature Review, and Proposed Management Model
- Author
-
Eryn Dow, Linda Mileshkin, Peter Jurcevic, Rodney J. Hicks, Susan Fawcett, George McGillivray, Mark D. Pertile, Mark Shackleton, Nicola Flowers, Martin B. Delatycki, Andrew Fellowes, Alison Freimund, Paul A. James, and Kortnye Smith
- Subjects
Adult ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Screening test ,Noninvasive Prenatal Testing ,Aneuploidy ,Maternal blood ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Medical diagnosis ,Fetus ,Obstetrics ,business.industry ,Management model ,Cancer ,medicine.disease ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Female ,business ,Pregnancy Complications, Neoplastic - Abstract
Noninvasive prenatal testing (NIPT) is a screening test for fetal chromosomal aneuploidy using cell-free DNA derived from maternal blood. It has been rapidly accepted into obstetric practice because of its application from 10-weeks' gestation, and its high sensitivity and specificity. NIPT results can be influenced by several factors including placental or maternal mosaicism and co-twin demise; cell-free DNA from a maternal origin can also complicate interpretation, with evidence that NIPT can detect previously unsuspected malignancies. This study aimed to develop management guidelines for women with NIPT results suspicious of maternal malignancy. The Peter MacCallum Cancer Center's experience of seven cases where abnormal NIPT results led to investigation for maternal malignancy between 2016 and 2019 were reviewed, along with the published literature. Six of the seven women (86%) referred for investigation were diagnosed with advanced malignancies, including colorectal cancer, breast cancer, melanoma, and Hodgkin lymphoma. Based on our single-center experience, as well as the available literature, guidelines for the investigation of women with NIPT results suspicious of malignancy are proposed, including utilization of fluorodeoxyglucose positron emission tomography-computed tomography, which had a high concordance with other investigations and diagnoses. These guidelines include maternal and fetal investigations, as well as consideration of the complex medical, psychologic, social, and ethical needs of these patients and their families.
- Published
- 2021
21. Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section
- Author
-
Rongli Xu, Li Xia, Wenqiang You, Yan Dai, and Jinxiao Lin
- Subjects
Adult ,medicine.medical_specialty ,China ,Uterine fibroids ,Lochia ,medicine.medical_treatment ,Enucleation ,Uterus ,Postoperative fever ,Pregnancy ,Medicine ,Humans ,Retrospective Studies ,Leiomyoma ,business.industry ,Uterine myomectomy ,Research ,Obstetrics and Gynecology ,Perioperative ,Gynecology and obstetrics ,medicine.disease ,Prognosis ,female genital diseases and pregnancy complications ,Surgery ,medicine.anatomical_structure ,Uterine Neoplasms ,RG1-991 ,Female ,business ,Cesarean section ,Pregnancy Complications, Neoplastic ,Uterine large fibroids - Abstract
Introduction A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section. Methods The medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results No significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p p p Conclusion Fibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.
- Published
- 2021
22. A 31-Year-Old Pregnant Woman With Asthma, Presenting With Worsening Dyspnea, Wheeze, and Hoarseness
- Author
-
Patrick Koo, Jetina Okereke, and Mia Malin
- Subjects
Adult ,Pulmonary and Respiratory Medicine ,Spirometry ,Pediatrics ,medicine.medical_specialty ,Paclitaxel ,Antineoplastic Agents ,Critical Care and Intensive Care Medicine ,Carboplatin ,Diagnosis, Differential ,Pregnancy ,Prednisone ,Wheeze ,medicine ,Humans ,Laryngeal Neoplasms ,Cyclin-Dependent Kinase Inhibitor p16 ,Asthma ,Hoarseness ,Laryngoscopy ,Radiotherapy ,medicine.diagnostic_test ,Cesarean Section ,Squamous Cell Carcinoma of Head and Neck ,business.industry ,Inhaler ,Papillomavirus Infections ,Alcohol dependence ,medicine.disease ,Dysphagia ,Treatment Outcome ,Female ,medicine.symptom ,Deglutition Disorders ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Pregnancy Complications, Neoplastic ,medicine.drug - Abstract
Case Presentation A 31-year-old woman (gravida 3 and para 1-0-1-1 at 20 weeks gestation) was admitted to the hospital for a presumed acute asthma exacerbation. She had a history of severe persistent asthma since childhood. She described her symptoms as progressively worsening since the beginning of her pregnancy. In addition to her dyspnea and wheeze, both of which occurred at rest and with exertion, she complained of worsening hoarseness and mild dysphagia of solid foods over the week before admission. Her primary care provider treated her with a combined corticosteroid and long-acting beta-agonist inhaler, albuterol inhaler and nebulizer, azithromycin, and two courses of prednisone without improvement. Her allergist performed a handheld spirometry 2 months before admission that was repeated 3 weeks later in the office. She had a social history of alcohol dependence but had been sober for 9 months. She was a former one-pack-per-day smoker but quit 20 weeks before admission and used marijuana occasionally. She had no known occupational or inhalation exposures.
- Published
- 2021
23. Ultrasonographic evaluation of ovarian mass for predicting malignancy in pregnant women
- Author
-
Jong Kwan Jun, Won Joon Seong, Hye Sung Won, Hee Seung Kim, Mi-Young Lee, Sunghun Na, Hyun Joo Seol, Chan-Wook Park, Se Jin Lee, Seung Mi Lee, Ki Hoon Ahn, Jong Woon Kim, Han Sung Hwang, Soo-young Oh, Joong Shin Park, Young Han Kim, Hyun Sun Ko, and Moon Young Kim
- Subjects
Adult ,medicine.medical_specialty ,Malignancy ,Risk Assessment ,Iota ,Ovarian tumor ,Pregnancy ,medicine ,Humans ,Ovarian mass ,Retrospective Studies ,Ultrasonography ,Ovarian Neoplasms ,Ovarian cyst ,Receiver operating characteristic ,business.industry ,Ovary ,Ultrasound ,Obstetrics and Gynecology ,Prognosis ,medicine.disease ,Oncology ,Female ,Radiology ,business ,Pregnancy Complications, Neoplastic ,Maternal Age - Abstract
The purpose of this study is to compare ultrasonographic ovarian mass scoring systems in pregnant women.This multicenter study included women with an ovarian mass during pregnancy who were evaluated using ultrasound and underwent surgery in 11 referral hospitals. The ovarian mass was evaluated and scored using three different scoring systems(International Ovarian Tumor Analysis Assessment of Different NEoplasias in the adnexa[IOTA ADNEX], Sassone, and Lerner). The final diagnosis was made histopathologically. Receiver operating characteristic(ROC) curves were generated for each scoring system.During the study period, 236 pregnant women underwent surgery for an ovarian mass, including 223 women(94.5%) with a benign ovarian mass and 13 women(5.5%) with a malignant ovarian mass. Among 10 ultrasound image findings, six findings were different between benign and ovarian masses(maximal diameter of mass, maximal diameter of solid mass, wall thickness of mass, inner wall structure, thickness of septations, and papillarity). In all three scoring systems, the ovarian mass scores were significantly higher in malignant masses than in benign masses, with the highest area under the ROC curve(AUROC) in the Sassone scoring system(AUROC: 0.831 for Sassone, 0.710 for Lerner vs 0.709 for IOTA ADNEX; p 0.05, between the Sassone and Lerner/ IOTA ADNEX). A combined model was developed with the six different ultrasound findings, and the AUROC of the combined model was 0.883(p = not significant between the combined model and Sassone).In pregnant women, malignant ovarian tumors can be predicted with high accuracy using either the Sassone scoring system or the combined model.
- Published
- 2021
24. Timing of Presentation and Outcomes of Women with Stage IV Pregnancy-Associated Breast Cancer (PABC)
- Author
-
Regina Matar, Mary L. Gemignani, Angelena Crown, Varadan Sevilimedu, and Shari Goldfarb
- Subjects
Adult ,Azides ,medicine.medical_specialty ,Breast surgery ,medicine.medical_treatment ,Breast Neoplasms ,Triple Negative Breast Neoplasms ,Disease ,Abortion ,Article ,Propanolamines ,Breast cancer ,Pregnancy ,Interquartile range ,Surgical oncology ,medicine ,Humans ,Retrospective Studies ,Obstetrics ,business.industry ,Postpartum Period ,medicine.disease ,Confidence interval ,Oncology ,Female ,Surgery ,business ,Pregnancy Complications, Neoplastic - Abstract
Pregnancy-associated breast cancer (PABC) and concurrent, or early development of, stage IV disease is uncommon. Given this rarity, and complexities surrounding pregnancy, data are limited regarding PABC treatment and outcomes. We evaluated oncologic, obstetric, and fetal outcomes of women with stage IV PABC in relation to presentation timing and treatment. Our retrospective review of an institutional database identified women with stage IV PABC from 1998 to 2018. PABC was defined as diagnosis during pregnancy or ≤ 1 year postpartum. Clinicopathologic, treatment, and outcome variables were compared between women diagnosed during pregnancy versus postpartum. We identified 77 women (median age 35 years; interquartile range [IQR] 32–37 years): 51 (66%) in the postpartum group and 26 (34%) in the pregnant group, including 9 with therapeutic or spontaneous abortion. Among 17 women who continued pregnancy, no obstetric or fetal complications were noted. Clinicopathologic and treatment variables did not differ between groups. Of 43 women dead from disease, 15 had triple negative (TN) tumors. Median overall survival (OS) of TN tumors was 14 months (range 5−39 months); OS was associated with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2) positive tumors (p < 0.01). At 31 months (range 0−137 months) median follow-up, the 5-year OS was 34% (95% confidence interval 21–46%), and did not differ among pregnant and postpartum groups (p = 0.2). Women with stage IV TN PABC had high mortality rates despite multimodality therapy. Timing of presentation did not affect management decisions or OS, even for women who completed pregnancy. Further research to understand PABC biology, focusing on TN tumors, is warranted
- Published
- 2021
25. Change of uterine leiomyoma size during pregnancy and the influencing factors: A cohort study
- Author
-
Yu-Cui Tian, Hong-Mei Wang, Qian Wang, Yin-Mei Dai, and Jian-hong Wu
- Subjects
medicine.medical_specialty ,Cohort Studies ,Pregnancy ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,neoplasms ,Fetus ,Uterine leiomyoma ,Leiomyoma ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,musculoskeletal system ,medicine.disease ,female genital diseases and pregnancy complications ,body regions ,Parity ,surgical procedures, operative ,Uterine Neoplasms ,Gestation ,Female ,business ,Pregnancy Complications, Neoplastic ,Body mass index ,Cohort study - Abstract
OBJECTIVE To evaluate the changes of uterine leiomyoma size during pregnancy and determine the factors influencing it. METHODS A prospective study was conducted from June 2016 to June 2018. Women with pregnancies complicated by leiomyoma were recruited. Ultrasound examinations were conducted to measure the size of leiomyoma during 6-7, 11-14, 22-24, 28-34 weeks of pregnancy and before delivery. The clinical characteristics and delivery details of the pregnant women were collected. Changes in leiomyoma size during different gestation periods and the influencing factors were analyzed. RESULTS Leiomyoma size commonly increased before 22-24 weeks of pregnancy and the fastest growth occurred before 11-14 weeks. From 22-24 weeks to the date of delivery, the size of leiomyoma remained unchanged. The initial size of the leiomyoma showed negative correlation with the changes in leiomyoma diameters during pregnancy. Pre-pregnancy body mass index, fetus number, leiomyoma location, and parity were positively correlated with the size changes in leiomyoma from 22-24 to 28-34 weeks of pregnancy. CONCLUSION Before 22-24 weeks of pregnancy, the size of the leiomyoma was gestation-dependent, which increases with gestational weeks. The fastest growth rate was before 11-14 weeks. The growth of leiomyoma is affected by multiple factors, and different factors can play different roles during different periods of the pregnancy.
- Published
- 2021
26. A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008)
- Author
-
Yu-Chun Jin, Jun-Xian Du, Shao-Mei Fu, Qin Chen, Yi-Ran Qiu, An Pei, Yi-Jing Yao, Wei Zhu, Ke-Jin Wu, and Yan-Jie Yin
- Subjects
Adult ,China ,medicine.medical_specialty ,Breast surgery ,medicine.medical_treatment ,Breast Neoplasms ,Abortion ,Pregnancy-associated breast cancer ,Breast cancer ,Pregnancy ,medicine ,Humans ,Stage (cooking) ,Survival analysis ,Retrospective Studies ,Clinicopathological feature ,business.industry ,Obstetrics ,Incidence (epidemiology) ,Retrospective cohort study ,Original Articles ,General Medicine ,Prognosis ,medicine.disease ,Treatment ,Medicine ,Female ,Neoplasm Recurrence, Local ,business ,Pregnancy Complications, Neoplastic - Abstract
Background:. Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China. Methods:. According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method. Results:. A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24–47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3–59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died. Conclusions:. It is safe and feasible to standardize surgery and chemotherapy for PABC.
- Published
- 2021
27. Outcomes of the First Pregnancy After Fertility-Sparing Surgery for Early-Stage Cervical Cancer
- Author
-
Roni, Nitecki, Jessica, Floyd, Kelly, Lamiman, Mark A, Clapp, Shuangshuang, Fu, Kirsten, Jorgensen, Alexander, Melamed, Paula C, Brady, Anjali, Kaimal, Marcela G, Del Carmen, Terri L, Woodard, Larissa A, Meyer, Sharon H, Giordano, Pedro T, Ramirez, and J Alejandro, Rauh-Hain
- Subjects
Adult ,Adolescent ,Trachelectomy ,Conization ,Uterine Cervical Neoplasms ,Gravidity ,Cervix Uteri ,Article ,Cohort Studies ,Young Adult ,Pregnancy ,Humans ,Propensity Score ,Neoplasm Staging ,Fetal Growth Retardation ,Cesarean Section ,Infant, Newborn ,Pregnancy Outcome ,Fertility Preservation ,Obstetrics and Gynecology ,Middle Aged ,Stillbirth ,Carcinoma, Squamous Cell ,Premature Birth ,Female ,Pregnancy Complications, Neoplastic - Abstract
To evaluate outcomes of the first pregnancy after fertility-sparing surgery in patients with early-stage cervical cancer.We performed a population-based study of women aged 18-45 years with a history of stage I cervical cancer reported to the 2000-2012 California Cancer Registry. Data were linked to the OSHPD (California Office of Statewide Health Planning and Development) birth and discharge data sets. We included patients with cervical cancer who conceived at least 3 months after a fertility-sparing surgery, which included cervical conization or loop electrosurgical excision procedure. Those undergoing trachelectomy were excluded. The primary outcome was preterm birth. Secondary outcomes included growth restriction, neonatal morbidity, stillbirth, cesarean delivery, and severe maternal morbidity. We used propensity scores to match similar women from two groups in a 1:2 ratio of case group participants to control group participants: population individuals without cancer and individuals with cervical cancer (women who delivered before their cervical cancer diagnosis). Wald statistics and logistic regressions were used to evaluate outcomes.Of 4,087 patients with cervical cancer, 118 (2.9%) conceived after fertility-sparing surgery, and 107 met inclusion criteria and were matched to control group participants. Squamous cell carcinoma was the most common histology (63.2%), followed by adenocarcinoma (30.8%). Patients in the case group had higher odds of preterm birth before 37 weeks of gestation compared with both control groups (21.5% vs 9.3%, odds ratio [OR] 2.7, 95% CI 1.4-5.1; 21.5% vs 12.7%, OR 1.9, 95% CI 1.0-3.6), but not preterm birth before 32 weeks. Neonatal morbidity was more common among the patients in the case group relative to those in the cervical cancer control group (15.9% vs 6.9%, OR 2.5, 95% CI 1.2-5.5). There were no differences in rates of growth restriction, stillbirth, cesarean delivery, and maternal morbidity.In a population-based cohort, patients who conceived after surgery for cervical cancer had higher odds of preterm delivery compared with control groups.
- Published
- 2021
28. Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970–2018
- Author
-
Irma Fredriksson, Lene Mellemkjær, Jeanette Falck Winther, Anna L.V. Johansson, Frida E. Lundberg, Gustav J. Ullenhag, Hanne Stensheim, and Päivi M. Lähteenmäki
- Subjects
Pregnancy-associated cancer ,Cancer Research ,medicine.medical_specialty ,Survival ,endocrine system diseases ,Colorectal cancer ,education ,Population ,History, 21st Century ,Breast cancer ,Pregnancy ,Uterine cancer ,health services administration ,medicine ,Humans ,Registries ,Mortality ,Cancer ,Sweden ,Cancer och onkologi ,education.field_of_study ,Uterine sarcoma ,business.industry ,Obstetrics ,Proportional hazards model ,Hazard ratio ,food and beverages ,History, 20th Century ,medicine.disease ,Survival Analysis ,humanities ,Oncology ,Cancer and Oncology ,Female ,business ,Pregnancy Complications, Neoplastic - Abstract
Background Pregnancy-associated cancer (PAC) is increasing over time in many countries. We provide a comprehensive, population-based overview of cancer survival in women with PAC across five decades. Methods We performed a nationwide cohort study of 121,382 women diagnosed with cancer at age 15–49 between 1970 and 2018 using birth and cancer registers in Sweden. Pregnancy-associated cancer was defined as diagnosed during pregnancy and within one year of delivery, while non-PAC was outside this window. Cox regression estimated adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) comparing cancer mortality for PAC versus non-PAC. Results In total, 5079 women had a diagnosis of PAC. Cutaneous malignant melanoma, breast, cervical, thyroid and central nervous system (CNS) were the most common sites of PAC. A higher cancer mortality was observed in PAC versus non-PAC for breast (HR = 1.72, 95% CI 1.54–1.93) and uterine cancer (myometrium/unspecified) (8.62, 2.80–26.53), in which all PAC deaths were uterine sarcomas. Increased mortality was also observed in upper digestive tract cancer diagnosed during pregnancy and colon cancer diagnosed during first year after delivery. Contrary, the HR for CNS tumours was significantly decreased (0.71, 0.55–0.91). Survival after PAC improved for most sites over time, with survival after breast cancer during pregnancy in recent years being similar to that of non-pregnancy associated breast cancer. Conclusion For the majority of sites, PAC was not associated with poorer prognosis compared to non-PAC, a finding which was stable over time. The main exceptions were breast cancer and rarer cancers, such as uterine sarcoma.
- Published
- 2021
29. CHOROIDAL MELANOMA DURING PREGNANCY: A CASE REPORT AND REVIEW OF THE LITERATURE
- Author
-
Miguel A. Materin and Wajiha J. Kheir
- Subjects
Adult ,Choroidal melanoma ,medicine.medical_specialty ,MEDLINE ,Disease ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,0101 mathematics ,Melanoma ,Fetus ,Obstetrics ,business.industry ,Choroid Neoplasms ,Incidence (epidemiology) ,010102 general mathematics ,General Medicine ,medicine.disease ,eye diseases ,Ophthalmology ,Childbearing age ,030221 ophthalmology & optometry ,Female ,sense organs ,business ,Pregnancy Complications, Neoplastic - Abstract
Purpose To report a case of a woman diagnosed with choroidal melanoma during pregnancy, as well as review similar cases published in the literature. The prevalence, risk factors, treatment, prognosis, and outcomes of choroidal melanoma in pregnancy are addressed. Methods An extensive search of the literature was conducted by accessing PubMed, MEDLINE, and Scopus databases in January 2018 to identify cases of choroidal or uveal melanoma diagnosed during pregnancy. Patient A 37-year-old white woman pregnant with twins and diagnosed with choroidal melanoma. Results Choroidal melanoma in pregnancy has a prevalence ranging from 4.3% to 7.5% among women of childbearing age with the disease. Pregnancy has been linked to increased incidence of choroidal melanoma, but female hormones have not been shown to play a role in the pathogenesis of the disease. Other factors such as melanocyte-stimulation hormone and fetal-induced angiogenesis may be implicated. Choroidal melanoma in pregnancy has not resulted in a worse maternal or fetal outcome. Conclusion Although rare, choroidal melanoma in pregnancy is a clinical challenge. Management of these patients should be tailored to maternal and fetal needs.
- Published
- 2021
30. Spontaneous and induced abortions in women with a diagnosis of gestational related neoplasm: a population-based linkage study in Lombardy, 2010-2020.
- Author
-
Esposito G, Franchi M, Santucci C, Scarfone G, Parazzini F, La Vecchia C, Corrao G, and Negri E
- Subjects
- Female, Humans, Pregnancy, Cohort Studies, Prevalence, Pregnancy Complications, Neoplastic, Abortion, Induced adverse effects, Abortion, Spontaneous epidemiology, Abortion, Spontaneous etiology, Neoplasms diagnosis, Neoplasms epidemiology
- Abstract
Background: A diagnosis of cancer during pregnancy or within one year after the end of pregnancy is a major clinical and public health issue. The current study aimed at estimating the incidence of pregnancy-associated cancer (PAC) and assessing whether the risk of abortion is increased in women diagnosed with cancer., Methods: This population-based cohort study used the regional healthcare utilization (HCU) databases of Lombardy, the largest region in Italy, to identify the women who delivered between 2010 and 2020. PAC were identified by oncological ICD-9-CM codes reported in the hospital discharge forms. We computed the ratio of PAC cases to the total number of pregnancies. Following a diagnosis of PAC, the prevalence ratio (PR) of abortion and the corresponding 95% confidence interval (CI), was estimated using a log-binomial model adjusted for maternal age., Results: During the study period, 926 women who gave birth (1.29 cases per 1000 births) and 341 women who had an abortion (1.52 cases per 1000 abortions) were diagnosed with PAC. Regardless of the outcome of pregnancy, the risk of PAC increased with increasing age. The rate of PAC was initially lower among births, but it came very close to the rate of PAC among abortions in the last two calendar years. The proportion of abortions among women with PAC gradually decreased from 27.7% in 2010-2012 to 18.5% in 2019-2020 (p-value < 0.001). Overall, a diagnosis of PAC was related to an approximately 10% increased risk of abortion (PR = 1.11, 95%CI:1.01-1.22). However, no association was observed in 2019-2020 (PR = 0.87, 95%CI:0.65-1.17). Considering only diagnoses made during the first trimester of pregnancy, the risk of abortion was about 2.5 times higher (PR = 2.53, 95%CI:2.05-3.11) and the risk of induced abortion was almost 4 times higher (PR = 3.71, 95%CI:2.82-4.90)., Conclusion: In this population the risk of abortion was about 10% higher in women with PAC than in women without PAC. However, this association tended to decrease in more recent calendar periods. This trend seemed to be influenced more by spontaneous than by induced abortions., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
31. Primary Cutaneous Peripheral T-Cell Lymphoma-Not Otherwise Specified (pcPTCL-NOS) in Pregnancy.
- Author
-
Sahu P, Dayal S, Singh S, and Singh S
- Subjects
- Adult, Female, Humans, Male, Pregnancy, Anti-Bacterial Agents therapeutic use, Thigh, Pregnancy Outcome, Pregnancy Complications, Neoplastic, Lymphoma, T-Cell, Peripheral
- Abstract
A 25-year-old, 7-month pregnant woman presented with rapidly progressive multiple ulcerated nodules present for 5 months on her left thigh. The lesions began as small red-colored papules, becoming nodular within few days. Initially, she was treated with systemic antibiotics and analgesics, and later a local physician performed incision and drainage. The lesions further increased, becoming indurated and ulcerated. Two months after her delivery, the lesions had extended to the middle of the medial side of her left thigh. On admission, she had a history of fever and weight loss, but there was no trauma. She delivered a full-term healthy baby boy. Past and family history was not significant. Examination revealed 15-20 ill-defined, erythematous, immobile, and irregular nodules of varying sizes, measuring 4 × 5 cm
2 , and extending from the inguinal region to the middle portion on medial aspect of the left thigh (Figure 1). Some of the nodules ulcerated with yellow color discharge with crusting, attributed to secondary bacterial infection. Multiple palpable and matted inguinal lymph nodes were present in the left inguinal region.- Published
- 2023
32. Survival of women with pregnancy-associated breast cancer according to clinical characteristics: A propensity score matching study
- Author
-
Hongki Gwak, Sang Seok Woo, Eun-Sook Lee, Min Ho Park, Seokwon Lee, Hyun Jo Youn, Seho Park, In Suck Suh, and Seong Hwan Kim
- Subjects
Ki-67 Antigen ,Pregnancy ,Humans ,Breast Neoplasms ,Female ,Triple Negative Breast Neoplasms ,General Medicine ,Neoplasm Recurrence, Local ,Prognosis ,Propensity Score ,Pregnancy Complications, Neoplastic ,Retrospective Studies - Abstract
In recent years, postponing childbearing has increased the prevalence of pregnancy-associated breast cancer (PABC). PABC has a poorer prognosis than breast cancer not associated with pregnancy (non-PABC) due to delayed diagnosis and aggressive subtype. Additionally, pregnancy itself predicts a poor prognosis; but, this is a subject of debate. Thus, we analyzed the effects of known prognostic factors and pregnancy on the prognosis of PABC. We retrospectively analyzed women aged 20 to 49 years who were diagnosed with breast cancer (BC) between 1989 and 2014. Patients were distributed into PABC and non-PABC groups, and 1:4 propensity score matching was performed to adjust for baseline characteristics. Primary endpoints were overall survival (OS) and BC-specific survival (BCSS). Secondary endpoint was the difference in prognosis according to BC subtype. Of the 34,970 recruited patients with BC, 410 (1.2%) had PABC. Patients with PABC were younger and tended to have triple-negative BC (TNBC) subtype than non-PABC patients. The 1640 matched non-PABC patients showed a significantly worse mean survival rate than the unmatched non-PABC patients. Patients with PABC had a significantly worse OS and BCSS than those with non-PABC. In multivariate analyses, patients with PABC of luminal B (Ki-67 ≥14.0%) and TNBC subtypes had worse OS and BCSS than patients with non-PABC. Patients with PABC had poorer prognosis than non-PABC patients after adjusting for several prognostic factors. This difference was particularly significant in patients with the luminal B and TNBC subtypes.
- Published
- 2022
33. Treating Cancer in Pregnant Patients After Roe v Wade Overturned
- Author
-
Melissa Suran
- Subjects
Jurisprudence ,Pregnancy ,Neoplasms ,Abortion, Legal ,Government Regulation ,Humans ,Female ,Abortion, Induced ,General Medicine ,Pregnant Women ,Supreme Court Decisions ,Pregnancy Complications, Neoplastic ,United States - Abstract
This medical news feature discusses the challenges of treating pregnant patients diagnosed with cancer following the reversal of Roe v Wade.
- Published
- 2022
34. [Screening, diagnostics, and treatment of cervical cancer in pregnancy]
- Author
-
Anne, Hammer, Lise, Haubjerg, Hevy Sadraddin, Gibrael, Azalie, Winther, Lars Henning, Pedersen, Katrine, Fuglsang, and Pernille Tine, Jensen
- Subjects
Pregnancy ,Humans ,Mass Screening ,Uterine Cervical Neoplasms ,Female ,Pregnancy Complications, Neoplastic ,Early Detection of Cancer - Abstract
Cervical cancer is one of the most common cancers in pregnancy. Early diagnosis is of utmost importance for the outcome of the woman and her child. Vaginal bleeding in pregnancy should prompt gynaecological examination, and further diagnostic is needed in women with persistent symptoms. A decision on preservation of the pregnancy in women who are diagnosed with early-stage cervical cancer depends on stage and gestational age, as argued in this review.
- Published
- 2022
35. Study for risks of amniocentesis in anterior placenta compared to placenta of other locations
- Author
-
Masamitsu Nakamura, Hiroko Takita, Minako Goto, and Akihiko Sekizawa
- Subjects
Adult ,medicine.medical_specialty ,Fetal Membranes, Premature Rupture ,Placenta Diseases ,Placenta ,Pregnancy ,Risk Factors ,medicine ,Odds Ratio ,Humans ,Fetal loss ,Prospective Studies ,Risk factor ,Retrospective Studies ,medicine.diagnostic_test ,Leiomyoma ,business.industry ,Medical record ,Significant difference ,Obstetrics and Gynecology ,Odds ratio ,Gynecology and obstetrics ,medicine.disease ,Surgery ,Abortion, Spontaneous ,Puncture ,medicine.anatomical_structure ,Logistic Models ,Uterine Neoplasms ,Amniocentesis ,RG1-991 ,Female ,business ,Premature rupture of membranes ,Pregnancy Complications, Neoplastic - Abstract
Objective This study aimed to compare the risks of amniocentesis between anteriorly located placentas and placentas in other locations and assess the factors that cause procedure-related complications. Materials and methods We prospectively studied women with singleton pregnancies who underwent amniocentesis between 2014 and 2020. The amniocentesis puncture sites were determined using ultrasonography. Women were classified into two groups according to their placental location. Medical records were retrospectively reviewed and characteristics and complications were compared between the groups of patients with different placental locations. Results During the study period, 629 women underwent amniocentesis. Three cases (0.5%) of premature rupture of membranes and one case (0.3%) of fetal loss within four weeks of amniocentesis were found. Puncture failure was observed in 14 cases (2.2%). Puncture failure included procedures with failure to obtain an adequate sample and procedures requiring more than three needle insertions. There was no significant difference in the frequency of puncture failure between the two groups. Logistic regression analysis revealed that uterine myoma (odds ratio [OR] 11.92; 95% CI, 3.04–45.17) and tenting membrane (OR 33.57; 95% CI, 6.45–178.41) were associated with puncture failure. Conclusion Anteriorly located placenta is not a risk factor for amniocentesis-related adverse outcomes. Instead, puncture failure frequently occurs in case of uterine myoma and tenting membrane. If puncture failure occurs, or if the puncture is difficult to perform, then the procedure should be considered technically difficult and postponed until it can be more easily performed.
- Published
- 2021
36. Efficacy of well-planned management in patients with incarcerated gravid uterus: A case series and literature review
- Author
-
Satoru Takeda, Koki Samejima, Hiroyuki Seki, Kazunori Baba, Yasushi Takai, and Shigetaka Matsunaga
- Subjects
Adult ,medicine.medical_specialty ,Retroverted uterus ,Uterus ,Incarcerated gravid uterus ,Patient Care Planning ,Ultrasonography, Prenatal ,Pregnancy ,Prenatal Diagnosis ,medicine ,Humans ,In patient ,Uterine Retroversion ,Cervical canal ,Leiomyoma ,medicine.diagnostic_test ,Cesarean Section ,business.industry ,Obstetrics and Gynecology ,Magnetic resonance imaging ,Organ damage ,Gynecology and obstetrics ,medicine.disease ,Magnetic Resonance Imaging ,Obstetric Labor Complications ,Surgery ,Postpartum hemorrhage ,medicine.anatomical_structure ,Uterine Neoplasms ,RG1-991 ,Female ,business ,Pregnancy Complications, Neoplastic - Abstract
Objective Incarcerated gravid uterus is a condition in which uterine myoma and intraperitoneal adhesion lead to persistent uterine retroversion. Accurate diagnosis before cesarean section is crucial so that the procedure can be planned with regard to the spatial relationship between the uterine incision and other organs. This study investigated the effects of well-planned management on the outcome of cesarean sections. Materials and methods Four patients with incarcerated gravid uterus who received well-planned management and preoperative magnetic resonance imaging were compared with three unexpected patients who were operated without preoperative diagnosis. Results In the preoperatively diagnosed group, compared with the non-preoperatively diagnosed group, the frequency of cervical canal damage tended to be lower (0% vs. 100%), blood loss tended to be less (1171 ± 290 mL vs. 2000 ± 300 mL), and surgery duration tended to be shorter (82 ± 17 min vs. 147 ± 84 min). None of the preoperatively diagnosed cases required allogeneic blood transfusion, and no organ damage was observed. Conclusion The early detection of a suspected incarcerated uterus, and a thorough understanding of diagnostic methods and the use of preoperative magnetic resonance imaging and ultrasonography facilitate the safe performance of a cesarean section.
- Published
- 2021
37. Evaluation of a new foetal shielding device for pregnant brain tumour patients
- Author
-
Sang Won Kang, Seong-Hee Kang, Dong-Seok Shin, Seungwan Lee, Jin-Beom Chung, and Kyeong-Hyeon Kim
- Subjects
Organs at Risk ,medicine.medical_treatment ,R895-920 ,VMAT ,Radiation ,Pregnant patient ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,Medical physics. Medical radiology. Nuclear medicine ,0302 clinical medicine ,Fetus ,Radiation Protection ,law ,Pregnancy ,Scattering radiation ,Shielded cable ,Image Processing, Computer-Assisted ,Medicine ,Humans ,Scattering, Radiation ,Radiology, Nuclear Medicine and imaging ,Radiation Injuries ,RC254-282 ,business.industry ,Brain Neoplasms ,Phantoms, Imaging ,Radiotherapy Planning, Computer-Assisted ,Research ,Foetal dose ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Radiotherapy Dosage ,Equipment Design ,Volumetric modulated arc therapy ,Radiation therapy ,Oncology ,Foetal shielding device ,030220 oncology & carcinogenesis ,Electromagnetic shielding ,Dose reduction ,Female ,Radiotherapy, Intensity-Modulated ,business ,Tomography, X-Ray Computed ,Pregnancy Complications, Neoplastic ,Biomedical engineering - Abstract
Background The present study aimed to propose a new foetal shielding device for pregnant cancer patients to reduce the foetal dose associated with treatment techniques using multiple gantry angles, such as intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT). Methods Three shielding structures were designed to minimise the scattered and leaked radiation from various gantry angles and radiation scattering within the patient. The base-plate part that can be placed on the treatment couch was designed to reduce the scattered and leaked radiation generated at gantry angles located near 180°. A body shielding part that can cover the lower chest and abdomen was designed, and a neck-shielding structure was added to reduce the internal and external radiation scattering from the treatment area. Evaluation plans were generated to assess the foetal dose reduction by the foetal shielding device in terms of the shielding material thickness, distance from the field edge, and shielding component using the flattened 6 MV photon beam (6MV) and flattening filter-free 6 MV photon beam (6MV-FFF). In addition, the effectiveness of the foetal shielding device was evaluated in a pregnant brain tumour patient. Results The shielding material consisting of three parts was placed on frames composed of four arch shapes with a vertical curved structure, connection bar at the top position, and base plate. Each shielding part resulted in reductions in the radiation dose according to the treatment technique, as the thickness of the shielding material increased and the foetal dose decreased. In addition, a foetal dose reduction of approximately 50% was confirmed at 50 cm from the field edge by using the designed shielding device in most delivery techniques. In patients, the newly designed shielding structures can effectively eliminate up to about 49% of the foetal dose generated from various gantry angles used in VMAT or IMRT. Conclusions We designed a foetal shielding device consisting of three parts to effectively reduce the dose delivered to the foetus, and evaluated the device with various treatment techniques for a pregnant patient with brain tumour. The foetal shielding device shielded the scattered/leaked radiation from the treatment machine, and also effectively reduced internal scattering from the treatment area in the patient.
- Published
- 2021
38. Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma
- Author
-
Ciccarone, F., Biscione, A., Moro, Francesca, Fischerova, D., Savelli, L., Munaretto, M., Jokubkiene, L., Sladkevicius, P., Chiappa, V., Fruscio, R., Franchi, D., Epstein, E., Timmerman, D., Froyman, W., Valentin, L., Scambia, Giovanni, Testa, Antonia Carla, Moro F., Scambia G. (ORCID:0000-0003-2758-1063), Testa A. C. (ORCID:0000-0003-2217-8726), Ciccarone, F., Biscione, A., Moro, Francesca, Fischerova, D., Savelli, L., Munaretto, M., Jokubkiene, L., Sladkevicius, P., Chiappa, V., Fruscio, R., Franchi, D., Epstein, E., Timmerman, D., Froyman, W., Valentin, L., Scambia, Giovanni, Testa, Antonia Carla, Moro F., Scambia G. (ORCID:0000-0003-2758-1063), and Testa A. C. (ORCID:0000-0003-2217-8726)
- Abstract
Objective: To describe the clinical and ultrasound characteristics of ovarian carcinosarcoma. Methods: This was a retrospective multicenter study. Patients with a histological diagnosis of ovarian carcinosarcoma, who had undergone preoperative ultrasound examination between 2010 and 2019, were identified from the International Ovarian Tumor Analysis (IOTA) database. Additional patients who were examined outside of the IOTA study were identified from the databases of the participating centers. The masses were described using the terms and definitions of the IOTA group. Additionally, two experienced ultrasound examiners reviewed all available images to identify typical ultrasound features using pattern recognition. Results: Ninety-one patients with ovarian carcinosarcoma who had undergone ultrasound examination were identified, of whom 24 were examined within the IOTA studies and 67 were examined outside of the IOTA studies. Median age at diagnosis was 66 (range, 33–91) years and 84/91 (92.3%) patients were postmenopausal. Most patients (67/91, 73.6%) were symptomatic, with the most common complaint being pain (51/91, 56.0%). Most tumors (67/91, 73.6%) were International Federation of Gynecology and Obstetrics (FIGO) Stage III or IV. Bilateral lesions were observed on ultrasound in 46/91 (50.5%) patients. Ascites was present in 38/91 (41.8%) patients. The median largest tumor diameter was 100 (range, 18–260) mm. All ovarian carcinosarcomas contained solid components, and most were described as solid (66/91, 72.5%) or multilocular-solid (22/91, 24.2%). The median diameter of the largest solid component was 77.5 (range, 11–238) mm. Moderate or rich vascularization was found in 78/91 (85.7%) cases. Retrospective analysis of ultrasound images and videoclips using pattern recognition in 73 cases revealed that all tumors had irregular margins and inhomogeneous echogenicity of the solid components. Forty-seven of 73 (64.4%) masses appeared as a solid tumor with cystic areas.
- Published
- 2022
39. Fibroids in pregnancy: a growing or shrinking issue?
- Author
-
Jessica H. Selter, Thomas M. Price, and Benjamin S. Harris
- Subjects
Reproductive Medicine ,Leiomyoma ,Pregnancy ,Uterine Neoplasms ,Pregnancy Outcome ,Obstetrics and Gynecology ,Humans ,Female ,Pregnancy Complications, Neoplastic - Published
- 2022
40. Survival after breast cancer in women with a subsequent live birth: Influence of age at diagnosis and interval to subsequent pregnancy
- Author
-
Richard A. Anderson, Matteo Lambertini, Peter S. Hall, W. Hamish Wallace, David S. Morrison, Tom W. Kelsey, University of St Andrews. Sir James Mackenzie Institute for Early Diagnosis, University of St Andrews. Centre for Interdisciplinary Research in Computational Algebra, and University of St Andrews. School of Computer Science
- Subjects
MCC ,Adult ,Cancer Research ,Survival ,RC0254 Neoplasms. Tumors. Oncology (including Cancer) ,ER status ,Breast Neoplasms ,Survivorship ,3rd-DAS ,RC0254 ,Cohort Studies ,Young Adult ,Breast cancer ,SDG 3 - Good Health and Well-being ,Oncology ,Pregnancy ,RG Gynecology and obstetrics ,Humans ,Female ,Registries ,RG ,Child ,Live Birth ,Pregnancy Complications, Neoplastic - Abstract
Funding: This work was undertaken in part in the MRC Centre for Reproductive Health, (supported by MRC grant MR/N022556/1). ML acknowledges the Italian Association for Cancer Research (“Associazione Italiana per la Ricerca sul Cancro”, AIRC; MFAG 2020 ID 24698) and the Italian Ministry of Health (5 x 1000 funds 2017) for supporting his research in the field of breast cancer in young women and oncofertility. Background There remains a considerable concern among both patients and oncologists that having a live birth (LB) after breast cancer might adversely impact survival. Methods analysis of survival in a national cohort of women with breast cancer diagnosed at age 20–39 years between 1981 and 2017 (n = 5181), and subsequent LB using Scottish Cancer Registry and national maternity records. Cases had at least one subsequent LB, each was matched with up to six unexposed cases without subsequent LB, accounting for guaranteed time bias. Results In 290 women with a LB after diagnosis, overall survival was increased compared to those who did not have a subsequent LB, HR 0.65 (95%CI 0.50–0.85). Women with subsequent LB who had not had a pregnancy before breast cancer showed increased survival (HR 0.56, 0.38–0.82). There was a progressively greater interaction of subsequent LB with survival with younger age, thus for women aged 20–25 years, HR 0.30 (0.12–0.74) vs. those aged 36–39, HR 0.89 (0.42–1.87). In women with LB within five years of diagnosis, survival was also increased (HR 0.66; 0.49–0.89). Survival following LB was similar to unexposed women by ER status (both positive and negative) and in those known to have been exposed to chemotherapy. Conclusions This analysis provides further evidence that for the growing number of women who wish to have children after breast cancer, LB does not have a negative impact on overall survival. This finding was confirmed within subgroups, including the youngest women and those not previously pregnant. Publisher PDF
- Published
- 2022
41. Uterine fibroids in pregnancy
- Author
-
Mara Sobel, Sebastian Hobson, and Crystal Chan
- Subjects
Leiomyoma ,Pregnancy ,Uterine Neoplasms ,Pregnancy Outcome ,Humans ,Female ,General Medicine ,Pregnancy Complications, Neoplastic - Published
- 2022
42. Spontaneous rupture of renal angiomyolipoma during pregnancy
- Author
-
Mariana Mouraz Lopes dos Santos, Sara Marques Soares Proença, Maria Inês Nunes Pereira de Almeida Reis, Rui Miguel Almeida Lopes Viana, Luísa Maria Bernardo Martins, João Manuel dos Reis Colaço, and Filomena Maria Pinheiro Nunes
- Subjects
Angiomyolipoma/complications ,Angiomyolipoma/diagnosis ,Pregnancy complications, neoplastic ,Rupture, spontaneous ,Case reports ,Gynecology and obstetrics ,RG1-991 - Abstract
Renal angiomyolipoma is a benign tumor, composed of adipocytes, smooth muscle cells and blood vessels. The association with pregnancy is rare and related with an increased risk of complications, including rupture with massive retroperitoneal hemorrhage. The follow-up is controversial because of the lack of known cases, but the priorities are: timely diagnosis in urgent cases and a conservative treatment when possible. The mode of delivery is not consensual and should be individualized to each case. We report a case of a pregnant woman with 18 weeks of gestation admitted in the emergency room with an acute right low back pain with no other symptoms. The diagnosis of rupture of renal angiomyolipoma was established by ultrasound and, due to hemodinamically stability, conservative treatment with imaging and clinical monitoring was chosen. At 35 weeks of gestation, it was performed elective cesarean section without complications for both mother and fetus.
- Published
- 2014
- Full Text
- View/download PDF
43. Breast Cancer During Pregnancy: Retrospective Institutional Case Series
- Author
-
Tanja Ovcaricek and Erika Matos
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Biopsy ,R895-920 ,Aggressive phenotype ,Antineoplastic Agents ,Breast Neoplasms ,Triple Negative Breast Neoplasms ,03 medical and health sciences ,Medical physics. Medical radiology. Nuclear medicine ,0302 clinical medicine ,Breast cancer ,breast cancer ,Pregnancy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Breast ,Adverse effect ,skin and connective tissue diseases ,therapeutic strategy ,Excess toxicity ,clinical characteristics ,Mastectomy ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Blue dye ,business.industry ,medicine.disease ,Oncology ,030220 oncology & carcinogenesis ,Female ,Electronic database ,prognosis ,Biopsy, Large-Core Needle ,Guideline Adherence ,Pregnancy Trimesters ,business ,Pregnancy Complications, Neoplastic ,Rare disease ,Research Article - Abstract
Background Pregnancy associated breast cancer is a rare disease. It presents a unique entity of breast cancer with aggressive phenotype. The main aim was to evaluate how the international guidelines were followed in daily practice. Patients and methods Data concerning patients’ and tumours’ characteristics, management, delivery and maternal outcome were recorded from institutional electronic database. In this paper a case series of pregnant breast cancer patients treated at single tertiary institution between 2007 and 2019 are presented and the key recommendations on managing such patients are summarized. Results Fourteen patients met the search criteria. The majority of tumours were high grade, triple negative or HER2 positive, two patients were de novo metastatic. Treatment plan was made for each patient by multidisciplinary team. Eight patients were treated with systemic chemotherapy with no excess toxicity or severe maternal/fetal adverse effects. In all but two patients, delivery was on term and without major complications. Only one event, which was not in whole accordance with international guidelines, was identified. It was the use of blue dye in one patient. Conclusions Women with pregnancy associated breast cancer should be managed like non-pregnant breast cancer patients and should expect a similar outcome, without causing harm to the unborn child. To achieve a good outcome in pregnancy associated breast cancer, a multidisciplinary approach is mandatory.
- Published
- 2021
44. Robotic Adrenalectomy for Functional Adenoma in Second Trimester Treats Worsening Hypertension
- Author
-
Thenappan Chandrasekar, Christopher Sebastiano, Costas D. Lallas, Huda B. Al-Kouatly, Courtney Capella, and May Jean Counsilman
- Subjects
Adenoma ,Adult ,medicine.medical_specialty ,Pregnancy ,Obstetrics ,business.industry ,Urology ,Adrenalectomy ,medicine.medical_treatment ,Adrenal Gland Neoplasms ,MEDLINE ,medicine.disease ,Robotic Surgical Procedures ,Second trimester ,Pregnancy Trimester, Second ,Hypertension ,medicine ,Humans ,Female ,business ,Pregnancy Complications, Neoplastic - Published
- 2021
45. Fertility considerations in targeted biologic therapy with tyrosine kinase inhibitors: a review
- Author
-
Marcos I Cordoba Munoz, Anupama Rambhatla, Michael R. Strug, Jessica Garcia De Paredes, and Mili Thakur
- Subjects
0301 basic medicine ,medicine.medical_specialty ,media_common.quotation_subject ,Fertility ,Review ,Abortion ,Miscarriage ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Neoplasms ,Genetics ,Humans ,Medicine ,Molecular Targeted Therapy ,Fertility preservation ,Protein Kinase Inhibitors ,Genetics (clinical) ,media_common ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Fertility Preservation ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,respiratory tract diseases ,Discontinuation ,030104 developmental biology ,Reproductive Medicine ,Term Birth ,Female ,business ,Live birth ,Pregnancy Complications, Neoplastic ,Developmental Biology - Abstract
PURPOSE: To review the impact of tyrosine kinase inhibitors (TKIs) on fertility in men and women, embryo development, and early pregnancy, and discuss considerations for fertility preservation in patients taking TKIs. METHODS: A comprehensive literature search using the PubMed database was performed through February 2021 to evaluate the current literature on imatinib, nilotinib, dasatinib, and bosutinib as it relates to fertility and reproduction. Published case series were analyzed for pregnancy outcomes. RESULTS: TKIs adversely affect oocyte and sperm maturation, gonadal function, and overall fertility potential in a self-limited manner. There are insufficient studies regarding long-term consequences on fertility after discontinuation of TKIs. A total of 396 women and 236 men were on a first- or second-generation TKI at the time of conception. Of the women with detailed pregnancy and delivery outcomes (n = 361), 51% (186/361) resulted in a term birth of a normal infant, 4.3% (16/361) of pregnancies had a pregnancy complication, and 5% (20/361) of pregnancies resulted in the live birth of an infant with a congenital anomaly. About 22% of pregnant women (87/396) elected to undergo a termination of pregnancy, while 16% (63/396) of pregnancies ended in a spontaneous abortion. In contrast, of the 236 men, 87% conceived pregnancies which resulted in term deliveries of normal infants. Elective terminations, miscarriage rate, pregnancy complication rate, and incidence of a congenital malformation were all less than those seen in females (4%, 3%, 2%, and 2.5%, respectively). CONCLUSION: Women should be advised to avoid conception while taking a TKI. Women on TKIs who are considering pregnancy should be encouraged to plan the pregnancy to minimize inadvertent first trimester exposure. In women who conceive while taking TKIs, the serious risk of relapse due to discontinuation of TKI should be balanced against the potential risks to the fetus. The risk of teratogenicity to a fathered pregnancy with TKI use is considerably lower. Fertility preservation for a woman taking a TKI can be considered to plan a pregnancy with a minimal TKI-free period. With careful monitoring, providers may consider a TKI washout period followed by controlled ovarian stimulation to cryopreserve oocytes or embryos, with a plan to resume TKIs until ready to conceive or to transfer an embryo to achieve pregnancy quickly. Fertility preservation is also indicated if a patient on TKI is requiring a gonadotoxic therapy or reproductive surgery impacting fertility.
- Published
- 2021
46. Spinal cord glioblastoma during pregnancy: Case report
- Author
-
Djamel Kitumba, J. Silva Gomes, and A. Marques Baptista
- Subjects
Adult ,medicine.medical_specialty ,Thoracic Vertebrae ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Humans ,Medicine ,Spinal Cord Neoplasms ,business.industry ,Infant, Newborn ,medicine.disease ,Spinal cord ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Cervical laminectomy ,030220 oncology & carcinogenesis ,Cervical Vertebrae ,Female ,Neurology (clinical) ,Glioblastoma ,business ,Pregnancy Complications, Neoplastic ,030217 neurology & neurosurgery - Abstract
Spinal Cord Glioblastoma Multiforme (SCGBM) is a very rare, debilitating and often fatal tumor. Cases of intracranial GBM during pregnancy have been reported, and as other tumor occurring in this setting, it harbors a great dilemma to attending physicians and families. We report the first case of a SCGBM diagnosed during pregnancy and discuss its management and treatment.
- Published
- 2021
47. Medulloblastoma during pregnancy: Hormone-mediated association? Report of 2 cases
- Author
-
A. Valarezo Chuchuca, Xavier Wong-Achi, and L. Ullauri Torres
- Subjects
Oncology ,medicine.medical_specialty ,medicine.drug_class ,Pathogenesis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Internal medicine ,medicine ,Adjuvant therapy ,Humans ,Cerebellar Neoplasms ,Gonadal Steroid Hormones ,neoplasms ,Medulloblastoma ,business.industry ,Incidence (epidemiology) ,medicine.disease ,nervous system diseases ,stomatognathic diseases ,Estrogen ,030220 oncology & carcinogenesis ,Female ,Surgery ,Neurology (clinical) ,business ,Pregnancy Complications, Neoplastic ,030217 neurology & neurosurgery ,Rate of growth ,Hormone - Abstract
Objective To report two rare cases of medulloblastoma in pregnant patients and a review of the literature. Material and methods Report of patients diagnosed with medulloblastoma during their pregnancies, who were treated with surgery and adjuvant therapy. We also reviewed other cases reported in the literature and the association made with hormonal receptors. Results Brain tumors in coincidence with pregnancy are unusual, and the incidence of medulloblastoma in pregnancy is still rarer. We found 8 cases of medulloblastomas diagnosed during pregnancy. Reports suggest that hormonal changes and increases in the levels of growth factors and angiogenic factors during pregnancy influence the rate of growth of brain tumors (not only medulloblastomas but also meningiomas or glial tumors). Conclusions The uniqueness of these cases is their rarity. The symptoms are usually masked by the symptoms of pregnancy. At present, there is still little evidence regarding the pathogenesis and treatment of medulloblastoma in pregnancy.
- Published
- 2021
48. Early Stage Pregnancy During Radiation Therapy to the Breast
- Author
-
Jose R. Teruel, Naamit K. Gerber, and Jerome M. Karp
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Breast Neoplasms ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Pregnancy ,Unplanned pregnancy ,Radiation oncology ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Breast ,Stage (cooking) ,Thoracic Wall ,Mastectomy ,business.industry ,General surgery ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,business ,Pregnancy Complications, Neoplastic ,Thoracic wall - Abstract
We describe a model case of unplanned pregnancy during radiation therapy to the chest wall and peripheral lymphatics for breast cancer. We use the Morbidity and Mortality Conference format to demonstrate how radiation oncology departments should evaluate and manage this situation.
- Published
- 2021
49. Management of pregnancy in women with cancer
- Author
-
Charlotte Maggen, Ingrid A. Boere, Elyce Cardonick, Liesbeth Lenaerts, Joosje Heimovaara, Vera E. R. A. Wolters, Frédéric Amant, Medical Oncology, and Obstetrics
- Subjects
medicine.medical_specialty ,Breastfeeding ,Antineoplastic Agents ,Review ,Disease ,carcinoma ,Metastasis ,surgery ,SDG 3 - Good Health and Well-being ,Pregnancy ,Neoplasms ,Neoplasms/therapy ,Humans ,Medicine ,Adverse effect ,Prenatal Care/methods ,radiotherapy ,Pregnancy Complications, Neoplastic/therapy ,business.industry ,Obstetrics ,Standard treatment ,Pregnancy Outcome ,Obstetrics and Gynecology ,Cancer ,Prenatal Care ,medicine.disease ,Antineoplastic Agents/administration & dosage ,Oncology ,Female ,Pregnancy Trimesters ,business ,Pregnancy Complications, Neoplastic ,Cohort study - Abstract
As the incidence of cancer in pregnancy has been increasing in recent decades, more specialists are confronted with a complex oncologic–obstetric decision-making process. With the establishment of (inter)national registries, including the International Network on Cancer, Infertility and Pregnancy, and an increasing number of smaller cohort studies, more evidence on the management of cancer during pregnancy is available. As fetal, neonatal, and short-term pediatric outcomes after cancer treatment are reassuring, more women receive treatment during pregnancy. Prenatal treatment should adhere to standard treatment as much as possible to optimize maternal prognosis, always taking into account fetal well-being.In order to guarantee the optimal treatment for both mother and child, a multidisciplinary team of specialists with expertise should be involved. Apart from oncologic treatment, a well-considered obstetric and perinatal management plan discussed with the future parents is crucial. Results of non-invasive prenatal testing are inconclusive in women with cancer and alternatives for prenatal anomaly screening should be used. Especially in women treated with chemotherapy, serial ultrasounds are strongly recommended to follow-up fetal growth and cervical length. After birth, a neonatal assessment allows the identification of any cancer or treatment-related adverse events. In addition, placental histologic examination aims to assess the fetal risk of metastasis, especially in women with malignant melanoma or metastatic disease. Breastfeeding is discouraged when systemic treatment needs to be continued after birth. At least a 3-week interval between the last treatment and nursing is recommended to prevent any treatment-induced neonatal effects from most non-platinum chemotherapeutic agents. ispartof: International Journal Of Gynecological Cancer vol:31 issue:3 pages:314-322 ispartof: location:England status: published
- Published
- 2021
50. Risks of molecular targeted therapies to fertility and safety during pregnancy: a review of current knowledge and future needs
- Author
-
Matteo Simonelli, Pasquale Persico, Armando Santoro, Angelo Dipasquale, and Elena Lorenzi
- Subjects
Male ,medicine.medical_specialty ,media_common.quotation_subject ,Population ,Antineoplastic Agents ,Molecular Targeted Therapies ,Fertility ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Cancer Survivors ,Pregnancy ,Neoplasms ,medicine ,Animals ,Humans ,Pharmacology (medical) ,Molecular Targeted Therapy ,education ,Intensive care medicine ,media_common ,education.field_of_study ,business.industry ,Pregnancy Outcome ,Cancer ,General Medicine ,medicine.disease ,030220 oncology & carcinogenesis ,Female ,business ,Pregnancy Complications, Neoplastic - Abstract
As the population of young cancer survivors is increasing and a trend toward postponing pregnancy later in life is reported, more efforts are focused toward understanding treatment-induced sequelae, in particular, the effects of cancer and/or treatment on fertility.Whereas the fertility risk of cytotoxic agents for both men and women is well recognized, the impact of molecular-targeted therapy (MTT) on fertility parameters, their teratogenic potential and pregnancy outcome/management in case of an accidental exposure are not established. We update available clinical data on the impact of new MTTs on fertility in both sexes, their potential teratogenic effects and the outcome of pregnancy during accidental exposure. Agents are categorized by class and the potential relevance of their target signaling pathways to gonadal maturation.The majority of MTTs have worrying preclinical data discouraging their use during pregnancy and reinforcing the idea that they can induce impairment in gonadal function. However, it does not mean that all MTTs result in permanent infertility and that they should be completely avoided during pregnancy. The current review provides a critical evaluation on the most commonly used MTTs, offering a possible guide for clinicians.
- Published
- 2021
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.