Virilisation during Pregnancy in a Patient with Metastatic Colorectal Cancer

Area of Science:

• Obstetrics and Gynecology
• Oncology
• Reproductive Endocrinology

Background:

• Virilization during pregnancy is uncommon, with potential causes including adrenal, fetal, or ovarian pathologies.
• Pregnancy luteoma and hyperreactio luteinalis are the most frequent causes of virilization in pregnancy.
• Colorectal cancer (CRC) incidence during pregnancy is rare, and its symptoms can mimic common pregnancy discomforts, delaying diagnosis.

Purpose of the Study:

• To describe a rare case of a 25-year-old woman experiencing virilization alongside metastatic colorectal cancer during pregnancy.
• To discuss the diagnostic and therapeutic challenges associated with colorectal cancer in pregnant patients.
• To review the implications of cancer treatment on women of childbearing age.

Main Methods:

• Case report detailing clinical presentation, diagnostic workup, and management.
• Literature review on virilization causes during pregnancy and colorectal cancer in pregnancy.
• Discussion of diagnostic limitations (e.g., colonoscopy, CT scans) in pregnant patients.

Main Results:

• The patient presented with virilization in the context of metastatic colorectal cancer during pregnancy.
• Diagnosis and staging of colorectal cancer in pregnancy are complicated by contraindications to standard imaging and procedures.
• Treatment decisions are influenced by fetal gestational age, with implications for fertility and long-term management.

Conclusions:

• The co-occurrence of virilization and metastatic colorectal cancer in pregnancy is exceptionally rare.
• Delayed diagnosis of colorectal cancer during pregnancy is a significant concern due to overlapping symptoms and diagnostic hurdles.
• Management requires a multidisciplinary approach, balancing maternal cancer treatment with fetal well-being and considering future reproductive health.