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Gestation-related malignant musculoskeletal tumors
Ofer Merimsky1, Moshe Inbar, Josephine Issakov
1Unit of Bone and Soft Tissue Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. merimsky@zahav.net.it
Background:
The incidence of malignant musculoskeletal tumors during pregnancy is very low. The paucity of data precludes the drawing of solid conclusions regarding a standard approach.
Objectives:
To summarize our experience treating 13 pregnant women with malignant soft tissue or bone tumors.
Methods:
We conducted a retrospective analysis of 13 cases of patients with either soft tissue or bone sarcoma that developed or progressed during pregnancy or immediately after delivery.
Results:
The clinical presentation of the tumors was a growing mass and/or increasing pain and disability. Most of the masses were located in the lower part of the body and were of considerable size. Treatment given during gestation was limited to wide excision of the mass in the 28th week of gestation in one patient. All the patients reported disease progression during gestation. Vaginal delivery was possible in eight patients with no complications, cesarean section was carried out in three women, spontaneous miscarriage occurred in one and termination of pregnancy was performed in one patient.
Conclusions:
The diagnostic and therapeutic approaches should be tailored specifically in every pregnant woman in whom sarcoma is suspected.