Anca Zgură, Laurenţia Galeş, Prof. Breast, ovarian, and cervical cancer are the most rectal cancer is pain cancers diagnosed during pregnancy. The manifestations encountered in colorectal cancer, such as abdominal pain, constipation, vomiting, nausea, rectal bleeding and altered bowel movements, are also found in normal pregnancy.
In this paper, we present a case of colorectal cancer with hepatic metastasis diagnosed in a year-old rectal cancer is pain woman IIG, 1Pat 32 weeks of pregnancy. Keywords pregnancy, colorectal cancer, metastasis, teratogencity, chemotherapy Rezumat Incidenţa cancerului colorectal în timpul sarcinii este mică, de un caz la 1. Cancerul mamar, ovarian şi cel cervical sunt cele mai frecvente tipuri de cancer diagnosticate în timpul sarcinii. Manifestările întâlnite în cancerul colorectal, precum dureri abdominale, constipaţie, vărsături, greaţă, sângerări rectale şi tulburări intestinale, se întâlnesc şi în timpul sarcinii normale, făcând dificilă diagnosticarea pe parcursul sarcinii.
În această lucrare vă prezentăm cazul unei paciente de 36 de ani IIG, 1Pîn săptămâna a a de sarcină, diagnosticată cu cancer colorectal, prezentând şi metastaze hepatice. Cuvinte cheie cancer colorectal metastaze teratogenitate chimioterapie Introduction The incidence of colorectal cancer during pregnancy is reduced, being estimated at approximately one in every preganancies Breast, ovarian and cervical cancer are the most common cancers diagnosed during pregnancy 2.
The manifestations encountered in colorectal cancer, such as abdominal pain, constipation, vomiting, nausea, rectal bleeding and altered bowel movements, are also found in normal pregnancy rectal cancer is pain. Most of the colorectal cancers are missed and are diagnosed in advanced stages. Using the antineoplastic agents in a pregnant patient is a difficult decision, with many of safety and efficacy implications 6.
The treatment plan depends on the desire of the pregnant woman, the stage of the disease, the possible teratogenic effects of rectal cancer is pain antineoplastic agents and abortion We present in this paper a case of colorectal cancer with hepatic metastasis diagnosed in a patient at rectal cancer is pain weeks of pregnancy.
Figure 1. She also had constipation and anemia. She was initially evaluated by her gynecologist, who suggested a second opinion from a gastroenterologist, who performed an abdominal and pelvic IRM.
Pathology and Anatomy of the Anal Cancer:
The abdominal and pelvic IRM evaluation revealed global hepatomegaly mm cranio caudal right lobe, 97 mm antero-posterior left lobeand more lobular contour space replacement formation. The CT scan of the thorax was without rectal cancer is pain pulmonary determinations. There was no family history of cancer. The physical examination at the time was unremarkable, except for normal signs of pregnancy.
Cancerul colorectal în sarcină
The patient was anemic at the time of presentation, the hemoglobin level was 9. After the imagistic and biological evaluation, she was refered to a surgeon, who thought that her pregnancy would make difficult to receive prompt adjuvant therapy.
The patient was only week pregnant at the time of diagnosis. A caesarean section was performed, resulting in the birth of a premature baby, weighing g, who received an Apgar score of 9. During the same operation, a left hemicolectomy and right oophorectomy were also performed. The histopatological raport revealed a moderate adenocarcinoma G2six nodes were examinated, but only two were positive.
The histopatological examination of the ovary showed metastasis of moderate adenocarcinoma Krukenberg ovary. Before deciding on the initiation of chemotherapy, the patient experienced altered generalized status, medium ascites, pleurisy and gambling edema. She received a cycle of rectal cancer is pain chemotherapy consisting of cetuximab mg. The patient tolerated the therapy with supportive treatment and minimal hematologic and non-hematologic toxicities. After one month, we changed the chemotheray cycle with cetuximab, oxaliplatin and 5-FU, due to the improvement of the general state.
A follow-up CT scan after three months showed evolution in mild numerical regression of liver lesions.
The hepatomegaly was maintained. Fine fluid blade in dimensional regression. Without bone metastases. The adjuvant chemotherapy combined with targeted therapy using cetuximab has been considered for the patient in order to eradicate the metastatic disease.
Discussion Despite the low incidence rate of 0.
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Colorectal cancer is among the eight most common malignancies in pregnancy 2. Colorectal cancer in pregnancy represents a serious situation, and there are many challenging issues regarding the diagnosis and management in pregnancy.
Because the signs and simptoms are similar in pregnancy and colorectal cancer, the colorectal cancer can be concealed In our patient, the abdominal pain was misdiagnosed as a sign and simptom of a normal pregnancy. There are limitations and contraindications for using imaging tests during pregnancy.
IRM remains relatively safe in pregnancy and the best option to evaluate the colorectal cancer. Serum CEA is an important test used in the evaluation of patients with colorectal cancer CEA levels during pregnancy may be elevated and rectal cancer is pain be used for monitoring the response of the treatment 15, Due to the fact that colorectal cancer is encoutered in the eldery and rarerly in young patients, it is assumed that there are a number of predisposing factors, such as Lynch syndrome, Peutz-Jeghers syndrome and inflammatory bowel disease Another challenging issue is the treatment, which should be started as early for the mother, and is based on the gestational age and tumor stage.
If diagnosis occurs during the first trimester of pregnancy, it may be expected until the fetus becomes viable, but with significant tumor progression 18, If the diagnosis occurs after the 20th week of pregnancy, colon resection may be delayed. Chemotheray is safer in the second and third trimesters, when organogenesis is complete There are no human data for the effect of cetuximab in pregnancy The ovarian metastatic disease from colorectal cancer is another challenge.
The incidence of ovarian metastases from colorectal cancer rectal cancer is pain higher in pregnant women. The survival of the pregnant woman with ovarian metastases is poor.
Nesbitt et al. There are no fetal risk due to the malignancy itself, even in metastasis cases. The pregnant woman with colorectal cancer has a poor prognosis. A review of 15 cases revealed that all patients with colorectal cancer presented in stage IV, and these patients died in 12 months after delivery Conclusions Colorectal cancer in pregnancy represents a diagnostic and therapeutic challenge. Because the signs and simptoms are similar in pregnancy and colorectal cancer, the diagnosis of colorectal cancer is often delayed.
The therapeutic decison for a pregnant patient rectal cancer is pain colorectal cancer should involve a multidisciplinary team, and there must be taken into account the life of the unborn child and testicular cancer journal survival of the mother. Conflict of interests: The authors declare no conflict of interests.
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J Obstet Gynaecol. Colorectal cancer presenting with uncommon soft tissue invasion during pregnancy. Acta Obstet Gynecol Scand. Gastroenterol Clini Biol. Colecchia G, Nardi M. Colorectal cancer in pregnancy.
For quite some time, anal rectal cancer is pain cancer rectal cancer was not regarded as an individual pathology, but it was seen, instead, as a form of rectal cancer. The limit between the rectum and the anal canal was set as the anorectal line dentate line. Thus, the anatomical anal canal is located between the dentate line proximally and the anocutaneous line distally. In practice, upon the rectal touch, the anal canal is longer and it also includes the transitional cylindrical epithelium area located above the dentate line, the so-called surgical anal canal.
A case report. G Chir. Colon and rectal cancer in pregnancy. Cappell MS.
Distribuie pe: DESCRIERE This fourth edition of Surgery of the Anus, Rectum and Colon continues to redefine the field, with its comprehensive coverage of common and rare colorectal conditions, advances in the molecular biology and genetics of colorectal diseases, and new laparoscopic techniques. Contributions from international experts on specialized topics and various new illustrations ensure that the extensive text is not only current and authoritative, but easy to understand. No other book provides the expertise of a world-class editorial team with the cutting-edge knowledge you need to master colorectal surgery. Process Delivery in Colorectal Surgical Practice.
Gastrointestinal endoscopy in high-risk patients. Dig Dis. Brent RL. The effect of embryonic and fetal exposure to X-ray, microwaves, and ultrasound: counseling the pregnant and nonpregnant patient about these risks.
Semin Oncol. Prospective evaluation of different diagnostic techniques for the detection of liver metastases at time of primary resection of colorectal carcinoma. Eur J Rectal cancer is pain.
Colorectal cancer during pregnancy
Use of magnetic resonance imaging in pregnancy to diagnosis intussusception induced by colonic cancer. Obstet Rectal cancer is pain. Estrogen and progesterone receptors in colon tumors. Am J Clin Pathol. The Treatment of colorectal cancer during pregnancy: cytotoxic chemotherapy and targeted therapy challenges. Colorectal Carcinoma in Pregnancy. Arch Surg. Jeppesen JB, Østerlind K.
Successful twin pregnancy outcome after in utero exposure to FOLFOX for metastatic colon cancer: A case report and review of the literature. Cl Colorectal Cancer.