The diagnosis of digestive cancer in a pregnant woman can be difficult, because it can be disguised by the common signs and symptoms of pregnancy. Gastric cancer, especially undifferentiated adenocarcinoma associated with diffuse bone metastasis accompanied by hematological disorders, is exceptionally encountered and the prognosis is very poor.
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A mean survival period of months was attributed to gastric cancer with bone metastasis. The management of pregnancy-associated digestive cancer represents a challenge for clinicians, requiring a multidisciplinary approach.
Diagnosticul poate fi dificil, deoarece poate fi mascat de semnele şi simptomele specifice sarcinii. Cancerul gastric, în special adenocarcinomul nediferenţiat asociat cu metastaze osoase difuze însoţite de tulburări hematologice, este întâlnit în mod excepţional, iar prognosticul este foarte rezervat.
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Un timp mediu de supravieţuire de luni a fost atribuit acestui stadiu. Managementul cancerului digestiv întâlnit în sarcină reprezintă o provocare pentru obstetrician şi necesită o abordare multidisciplinară.
The physiological changes occur in pregnancy during the fetal development and have the role to prepare the mother abdominal cancer age labor and delivery 1. It is important to differentiate between normal and pathological changes, because some physiologic changes mimic the symptoms of a variety of conditions, and vice versa 1.
Pregnancy involves changes in maternal physiology, including alterations in hematologic parameters like expansion in maternal blood and plasma volume 1,2. Thus, the result is that, the increasing in plasma volume, which is relatively larger than the increase in red cell mass, will cause a decrease in hemoglobin concentration 1,2.
Generally, the predominant cause of anemia in pregnancy is iron deficiency 2. However, oxygen-carrying capacity remains normal during pregnancy 3.
Cancer in abdominal area
Hematocrit normally increases immediately after birth 3. Several types of anemia can develop during pregnancy. The most common causes include iron deficiency, folate deficiency and vitamin B12 deficiency 4.
The early symptoms of anemia are usually non-specific 5. The most common symptoms of anemia are: fatigue, weakness, shortness of breath, dizziness, light headaches, shortness of breath, chest pain, and cold hands and feet 5. Other signs may include pallor and, if the anemia is severe, tachycardia or hypotension 5,6.
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe 6. Anemia increases the risk of preterm delivery and postpartum maternal infections 7,8.
Also, anemia is the only symptom in different types of cancers occurring during pregnancy. Materials and method We performed an observational retrospective analysis of all women diagnosed with digestive cancer during pregnancy admitted in the Department of Abdominal cancer age and Gynecology of the Bucharest University Emergency Hospital, a tertiary center in Romania, between the 1st of January and the 31st of October The information regarding pregnancy, delivery outcomes and neonatal data was retrieved from the hospitalization sheets and the data base system of the Bucharest University Emergency Hospital.
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We analyzed the types of anemia and the incidence of pregnancy-associated anemia in order to determine correlations between anemia and digestive cancers. The most frequent pathologies associated with anemia in pregnancy were also studied. Extensive histopathological analysis and comparison between the types of cancer were also performed in order to determine the correlations between the signs and symptoms, the severity of anemia and a particular type of digestive cancer during pregnancy.
Results A total of abdominal cancer age, pregnant patients, with a gestational age over 20 weeks of amenorrhea, were admitted in the Department of Obstetrics and Gynecology of the Bucharest University Emergency Hospital between the 1st of January and the 31st of October The incidence of pregnancy-associated anemia was This percentage corresponds to the analysis of cases of pregnancy-associated anemia admitted in our unit during abdominal cancer age three years.
Cancer abdominal area.
As shown in Figure 1, the predominant conditions that lead to pregnancy-related anemia are spontaneous Many other pathologies related to anemia in pregnancy appeared with a lower incidence. During the three-year period, three pregnant women were diagnosed with a digestive type of cancer.
Two patients were diagnosed with gastric cancer and one of them with colon cancer. All three women were aged between 30 and 39 years old and were diagnosed with metastatic disease. Regarding the parity, the patients were primiparous or abdominal cancer age. At the time when the patients were diagnosed, they were between 23 and 33 weeks of gestations.
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The two patients with gastric cancer were diagnosed early, at 23 weeks and 24 weeks of pregnancy, while the patient with colon cancer was diagnosed at 33 weeks of amenorrhea. None of the patients had a personal medical or family history of malignancy. The symptoms of the patients were various, but they were all correlated with a digestive condition.
The patient with colon cancer, etiologia enterobiozei the time of the admission in abdominal cancer age hospital, had abdominal pain, constipation and a history of multiple hospitalizations for sub-occlusive episodes.
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Both patients with gastric cancer presented nausea and fatigue in the moment of the hospitalization. At the physical examination, all three patients presented pale teguments and mucous membranes and they were all known with anemic syndrome from the first trimester of pregnancy, treated with iron supplements. The blood samples revealed anemia with different levels of hemoglobin, between 6. The patient with colon cancer had the liver markers seriously modified, with high levels of direct bilirubin, fibrinogen and transaminases.
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All three patients were tested for tumor markers: alpha-fetoprotein, carcinoembryonic antigen, CA and CA The patient with 23 weeks of pregnancy and gastric cancer and the patient with colon cancer had a positive result for CA Figure 1. The main conditions associated to anemia in pregnancy Figure 2. Intraprocedural aspects of abdominal cancer age esophagogastroduodenoscopy performed in the patient with 24 weeks of gestation — note a large infiltrative mass located giardia lamblia parazit nedir the antral region of the stomach In both patients with gastric abdominal cancer age, a bone marrow trephine biopsy was performed.
It suggested metastases with a high suspicion of a primary gastric tumor, therefore an esophagogastroduodenoscopy was realized, which detected an infiltrative mass in the stomach body Figure 2. Biopsies were taken and the histopathological examination confirmed the diagnosis of gastric cancer Figure 3 and Figure 4.
All three patients underwent an abdominal ultrasound examination. The patient with colon cancer had severe hepatomegaly, the patient with 23 weeks of pregnancy had suggestive images for hepatic metastases, adenopathy and splenomegaly, and the other patient with gastric cancer had only a mild hepatomegaly.
Regarding the obstetrical exam, the patients with viable pregnancy had no clinical features or signs of preterm labor.
Abdominal cancer ascites Peritoneal cancer no symptoms Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz Peritoneal cancer with ascites Ovarian high-grade serous carcinoma is a type of malignancy that is rare among young adult women, being more frequent in postmenopausal women. Medlife Formular de căutare Înțelesul "ascites" în dicționarul Engleză Cum pot afecta radiatiile organismul uman? Ovarian cancer nausea Lista principalelor căutări efectuate de utilizatori pentru abdominal cancer age dicționarului nostru online înEngleză și cele mai întrebuințate expresii cu cuvântul «ascites». Implementarea acestuia se bazează pe analizarea frecvenței de apariție a termenului «ascites» în sursele digitalizate tipărite în Engleză între anul și până în prezent.
All three pregnancies were periodically evaluated by ultrasound. Both pregnancies developed with no issues related to the fetus, such as intrauterine growth restriction or small for gestational age.
The patient with colon cancer and the one with gastric cancer and 24 weeks of pregnancy benefited from an MRI scan, which revealed, in the patient with colon cancer, lesions with malignant features in the hepatic parenchyma or metastases from an extrahepatic source, while the other patient had pelvic bone metastases.
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The other patient with gastric cancer benefited from an emergency CT scan, confirming the multiple metastases and the adenopathy. The evolution of the pregnant woman with 23 weeks of gestation and gastric cancer was extremely aggressive and after four days of hospitalization she suffered a cardiac arrest.
For the patient with colon cancer, a caesarean section at 33 weeks of pregnancy was performed and a single live male fetus, weighting grams, with an Apgar score of 8, was extracted. During the surgery, the right ovary appeared with malignant modifications and the histopathological exam revealed a colonic-type adenocarcinoma — Krukenberg tumor, the certain diagnosis Figure 5.
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After almost one month, she received chemotherapy. The patient with 24 weeks of pregnancy and gastric abdominal cancer age was stabilized and after 10 days she was released and started chemotherapy.
Figure 3. Microscopic photographs of well-differentiated gastric tubular adenocarcinoma mimicking the normal gastric fundic gland with irregular branching and angulated structures invading the lamina propria. Hematoxylin-eosin staining, ob.
Pregnancy-associated digestive cancer – diagnosis and management
Signet ring gastric carcinoma. Note the monotonous proliferation of signet ring cells with intracellular mucin that displaces nucleus to side. Moderately differentiated colonic adenocarcinoma consisting of large, atypical cells that form pseudoglandular structures of various sizes.
Hematoxylin-eosin staining, ob. Obviously, the tratament de helmint în boala autoimună of anemia in the pregnant population is much higher, considering that only severe cases of anemia or cases associated with other pathologies are admitted.
Although a rare and challenging condition, cancer during pregnancy should rapidly be identified and treated Fetal safety might be weighted for clinical decisions Anemia caused by blood loss is the most frequent in cancer during pregnancy At the outset, anemia can be mild and considered physiological in pregnancy, but the symptoms worsen as anemia worsens Gastric cancer, especially undifferentiated adenocarcinoma associated with condiloamele frecate bone metastasis abdominal cancer age by hematological disorders, is exceptionally abdominal cancer age and the prognosis is very poor
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