Malignant fibrous histiocytoma during pregnancy: a case report

We present a case of a 38-year-old postpartum woman who had antepartal undiagnosed sarcoma with multiple metastasis. Although the patient underwent aggressive treatment with surgery and chemotherapy, she died 3 months after the vaginal delivery of a healthy female infant weighing 2,090 g at 35 weeks of gestation.

The patient had right shoulder pain and mild chest discomfort during the last trimester of the pregnancy. Six days after delivery, she came to our emergency room because her pain had become more severe. A humeral neck tumor with bone destruction was found in the right shoulder on X-ray. After detailed evaluation, right humeral surgery, cardiac surgery, and liver biopsy were performed. All the removed specimens were sent for pathologic examination, and the results showed a sarcoma favoring malignant fibrous histiocytoma with its primary origin in the left atrium.

Obstetricians should be aware that any non-specific complaint may be due to severe disease. It is better to evaluate all symptoms and signs that persist. In this case, early intervention such as radiologic imaging of the bone or echocardiography could have been performed during pregnancy to prevent tumor spread, maternal morbidity, and even death.