Administration of Gemcitabine for Metastatic Adenocarcinoma during Pregnancy: A Case Report and Review of the Literature

Wiesweg, Marcel; Aydin, Semra; Koeninger, Angela; Stein, Anja; Schara, Ulrike; Roye, Christoph van; Hense, J.; Welt, Anja; Schüler, Michael

doi:10.1055/s-0034-1368091

Cited by 13 publications

(2 citation statements)

References 33 publications

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“…The standard treatment for unresectable disease is fluoropyrimidine-based or gemcitabine-based chemotherapy. Wiesweg et al reported the use of gemcitabine and cisplatin in the 18th week of pregnancy in a 38-year-old woman diagnosed with metastatic adenocarcinoma of the biliary tract [ 18 ]. Those with locally advanced GBC may respond to newer adjuvant combination chemotherapy and molecular targeted therapeutic options.…”

Section: Discussionmentioning

confidence: 99%

The State of Perplexity During Management of Gall Bladder Malignancy in an Expectant Young Mother

Rajput¹,

Gupta²,

Gupta³

et al. 2021

Cureus

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During pregnancy, diagnosed cancer causes a major disturbance in the life of a pregnant woman and her family. The advanced stage of illness requiring systemic treatment inevitably leads the treating practitioner, with two lives at risk, into an ethical dilemma. The unborn child can be affected by the application of cancer medication to the mother as it is exposed to fetotoxic drugs. On the other hand, withholding therapy to allow fetal maturity may make the disease of the mother metastatic. Gall bladder carcinoma is often diagnosed as an unresectable disease (metastatic or locally advanced) due to its nonspecific symptomatology and carries the worst prognosis of any gastrointestinal or hepatobiliary neoplasm. We report a case of locally advanced gall bladder cancer (GBC) diagnosed during late pregnancy wherein the mother opted to continue the pregnancy without any intervention. A review of literature has been done to investigate the role of female hormones in a pregnancy complicating GBC with emphasis on management dilemma and the associated pitfalls.

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Section: Discussionmentioning

confidence: 99%

The State of Perplexity During Management of Gall Bladder Malignancy in an Expectant Young Mother

Rajput¹,

Gupta²,

Gupta³

et al. 2021

Cureus

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“…Liver diseases complicate the courses of about 3% of all pregnancies and may have detrimental effects on the mother and fetus, but CCA during pregnancy is rare. In PubMed database, 14 such cases have been identified during 1975 to 2019 [6][7][8][9][10][11][12][13][14][15][16][17][18][19] . Patients were aged 25 to 40 years, and no risk factor was identified in most patients.…”

Section: Discussionmentioning

confidence: 99%

Cholangiocarcinoma in pregnancy: a case report

Chow

Kong

2021

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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A 35-year-old pregnant woman presented at 19 weeks of gestation with epigastric pain and mildly elevated alanine transaminase level. She subsequently developed acute cholangitis, with deteriorated liver function. Imaging revealed features of cholangiocarcinoma. Termination of pregnancy was performed at 22 weeks of gestation to facilitate maternal treatment. She underwent hepatectomy, followed by multiple courses of chemotherapy and immunotherapy. However, she died from hepatorenal failure with hepatic encephalopathy 1 year later. Cholangiocarcinoma in pregnancy is rare. Although it is a differential diagnosis of deranged liver function in pregnancy, a precise diagnosis can be challenging as the presenting signs and symptoms are not obvious.

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Paclitaxel

2014

Reactions Weekly

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S Paclitaxel Polyneuropathy: case reportA 38-year-old pregnant woman developed polyneuropathy following treatment with paclitaxel for metastatic cholangiocellular adenocarcinoma.The woman in the 15th week of pregnancy was hospitalised for diabetes mellitus therapy; she was later diagnosed with metastatic cholangiocellular adenocarcinoma. Pregnancy was continued and cisplatin 50 mg/m 2 on day 1 and gemcitabine 1000 mg/m 2 on days 1 and 8 of a 21-day cycle were initiated. During cycle 2, administration of day 8 gemcitabine was deferred for 1 week due to leukocytopenia (grade 2). Antineoplastics were continued in prolonged cycles (11 to 12 days) due to haematotoxicity. Treatment was interrupted prior to gestational week 33 + 2, and the infant was delivered at week 35 by caesarean section. Cisplatin and gemcitabine were readministered with radiotherapy after delivery; however, disease progression ensued. Paclitaxel [route and dosage not stated] was initiated as third-line treatment, yet significant polyneuropathy ensued necessitating withdrawal of paclitaxel [duration of treatment to reaction onset and outcome not stated].Epirubicin was subsequently started; however, the woman later died.Author comment: "Thirdline therapy with paclitaxel was not tolerated due to severe polyneuropathy."Wiesweg M, et al. Administration of gemcitabine for metastatic adenocarcinoma during pregnancy: A case report and review of the literature. AJP Reports

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Administration of Gemcitabine for Metastatic Adenocarcinoma during Pregnancy: A Case Report and Review of the Literature

Cited by 13 publications

References 33 publications

The State of Perplexity During Management of Gall Bladder Malignancy in an Expectant Young Mother

The State of Perplexity During Management of Gall Bladder Malignancy in an Expectant Young Mother

Cholangiocarcinoma in pregnancy: a case report

Paclitaxel

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