Cancer and pregnancy

Betson, Johnnie R.; Golden, Max L.

doi:10.1016/s0002-9378(15)33519-5

Cited by 38 publications

(9 citation statements)

References 18 publications

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“…At what stage the fetus develops immunocompetence is not known [10]. Fetal immunologic response has been shown histologically as early as the second trimester.…”

Section: Discussionmentioning

confidence: 99%

Maternal Pulmonary Adenocarcinoma Metastatic to the Fetus: First Recorded Case Report and Literature Review

Walker

Reinisch

Monforte

2002

Pediatric Pathology & Molecular Medicine

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We report the ¢rst maternal pulmonary adenocarcinoma metastatic to the fetus, as well as an updated literature review. Review of the literature revealed that there have been only 67 cases of maternal malignancy metastatic to the products of conception.These were mostly malignant melanoma and hematopoietic tumors. A 46-year-old multiparous woman with metastatic pulmonary adenocarcinoma, diagnosed at 23 weeks gestation, delivered a male infant who appeared normal at birth.The mother died 2 days after delivery.The child developed multiple scalp tumors at 2 weeks ofage.The tumors recurred rapidly after initial resection.W|de local excision of the involved scalp and skin graft coverage was performed at 14 weeks of age. Histopathology of these tumors was identical to that of the maternal tumor. The maternal origin of these tumors was con¢rmed by £uorescence in situ hybridization (FISH).The child is now 5 years old and free of disease.Although the incidence of life-threatening neoplasms in pregnant women has been estimated to be approximately 1:1000 [1] to 1:1,500 [2], the incidence of metastases to the products of conception (POC) is surprisingly infrequent. The largest series reported to date is that of Ackerman and Gilbert-Barness, with 64 cases from the period 1866^1997 [3]. These nine cases of maternal pulmonary carcinoma were all metastatic to the placenta [4].This is the ¢rst reported case of metastatic pulmonary carcinoma to the fetus. We present a comprehensive review of the literature regarding this phenomenon, including theories on tumor biology and mechanisms of spread.

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“…At what stage the fetus develops immunocompetence is not known [10]. Fetal immunologic response has been shown histologically as early as the second trimester.…”

Section: Discussionmentioning

confidence: 99%

Maternal Pulmonary Adenocarcinoma Metastatic to the Fetus: First Recorded Case Report and Literature Review

Walker

Reinisch

Monforte

2002

Pediatric Pathology & Molecular Medicine

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“…At what stage the fetus develops immunocompetence is not known [10]. At what stage the fetus develops immunocompetence is not known [10].…”

Section: Discussionmentioning

confidence: 99%

Maternal Pulmonary Adenocarcinoma Metastatic to the Fetus: First Recorded Case Report and Literature Review

Walker

Reinisch

Monforte

2002

Pediatric Pathology & Molecular Medicine

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We report the first maternal pulmonary adenocarcinoma metastatic to the fetus as well as an updated literature review. Review of the literature revealed that there have been only 67 cases of maternal malignancy metastatic to the products of conception. These were mostly malignant melanoma and hematopoietic tumors. A 46-year old multiparous woman with metastatic pulmonary adenocarcinoma, diagnosed at 23 weeks gestation, delivered a male infant who appeared normal at birth. The mother died 2 days after delivery. The child developed multiple scalp tumors a 2 weeks of age. The tumors recurred rapidly after initial resection. Wide local excision of the involved scalp and skin graft coverage was performed at 14 weeks of age. Histopathology of these tumors was identical to that of the maternal tumor. The maternal origin of these tumors was confirmed by fluorescence in situ hybridization (FISH). The child is now 5 years old and free of disease.

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“…Pregnancy is contraindicated in the presence of an unresected liver adenoma or in one that has been partially resected. [1,6,12] It is estimated that in the year 2000 there will be 7,000 new cases of cancer of the brain and other central nervous system in women and 5,900 deaths. The tumors of the central nervous system that are most commonly adversely affected by pregnancy are pituitary adenomas, craniopharyngiomas, and meningiomas.…”

Section: Gastrointestinal Tract Tumorsmentioning

confidence: 99%

“…(5) Will the malignancy effect the fetus? (6) Will the therapy effect the fetus? (7) When should therapy be started?…”

Section: Introductionmentioning

confidence: 99%

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Malignant disease in pregnancy

Barber

2001

Journal of Perinatal Medicine

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Cancers in pregnancy are uncommon but do occur with an average frequency of 1 in 1,000 births. This gives rise to opposing emotional reactions in these women: they are happy they are pregnant, but usually devastated when they hear they have cancer. The major reasons for suspecting that pregnancy adversely affects the clinical course of cancer is the immunologic tolerance that characterizes both conditions. It has been pointed out that normal pregnancy and cancer are the only two biologic conditions in which the antigenic tissues is tolerated by a seemingly intact system. It may be stated that the mechanisms that insure the survival of fetus during pregnancy presumably also favors the progress of the neoplasia. Management requires individualization with careful thought as whether termination is necessary or whether continuing with the pregnancy is possible prior to definitive treatment. The physician's aim must be to cure the cancer and deliver live, healthy infants. This is one question when a joint decision is probably best reached among the obstetrician, surgical and medical oncologists and other disciplines. The life-threatening cancer should be managed both for the diagnosis and treatment as in the non-pregnant state. An early small cancer gives a better prognosis than an advanced cancer. The same holds for the non-pregnant patient. The survival in the non-pregnant patient stage for stage is the same as for the pregnant patient. However, all too often in the pregnant state the cancer is more advanced than in the non-pregnant patient. The disease must be evaluated and treated in full light of its exact location in conjunction with an understanding of the natural history within the context of the pregnancy with the potentially viable unborn infant. Concern that maternal cancer may metastasize to the fetus is not justified from a review of the accumulated literature. Infrequency of fetal involvement has led to speculation about biologic protective mechanisms that may exist for the placenta and the fetus and the role circulatory separation in the placenta and immunologic responses of the fetus may play. The association of cancer in pregnancy represents a major physiologic process for the maintenance of the race and a major pathologic process that accounts for numerous deaths. It presents a controlled growth and an uncontrolled growth in the same host.

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Cancer and pregnancy

Cited by 38 publications

References 18 publications

Maternal Pulmonary Adenocarcinoma Metastatic to the Fetus: First Recorded Case Report and Literature Review

Maternal Pulmonary Adenocarcinoma Metastatic to the Fetus: First Recorded Case Report and Literature Review

Maternal Pulmonary Adenocarcinoma Metastatic to the Fetus: First Recorded Case Report and Literature Review

Malignant disease in pregnancy

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