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[Colon cancer in pregnancy]
1Service de Chirurgie Digestive, Endocrinienne et Générale, CHU Dupuytren, Limoges. mathonnet@unilim.fr
Journal De Chirurgie
|September 19, 2003
Summary
Pregnancy-associated colon cancer, especially epidermoid type, presents unique challenges with delayed diagnosis and aggressive progression. Management requires careful consideration of maternal-fetal risks, with surgery as a primary option.
Area of Science:
- Oncology
- Obstetrics & Gynecology
- Surgical Oncology
Background:
- Colon cancer is rare during pregnancy.
- Pregnancy-associated colon cancers may exhibit increased obstruction, perforation, and metastasis.
- Pregnancy-induced immunotolerance might contribute to aggressive tumor behavior.
Observation:
- Epidermoid (squamous cell) carcinoma of the colon has not been previously reported in pregnant women.
- Symptoms of colon cancer can be masked by pregnancy, leading to diagnostic delays.
- Epidermoid colon cancer is an aggressive malignancy.
Findings:
- Surgical intervention below the diaphragm is feasible with acceptable maternal and fetal risk.
- Radiotherapy is contraindicated in this setting.
- Neoadjuvant chemotherapy may be considered, but fetal risks are not fully elucidated.
Implications:
- Therapeutic abortion in the first trimester can optimize maternal treatment.
- Chemotherapy or delayed treatment in later trimesters poses risks of fetal malformations, premature delivery, or reduced maternal survival.
- Multidisciplinary management is crucial for optimizing outcomes in this rare and aggressive condition.