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[A pregnant woman with gastric cancer and placental involvement]
T G Kleijn1,2, I Scholten3, H M Knol4
1Universitair Medisch Centrum Groningen, afd. Pathologie, Groningen.
Background:
About 200 pregnant women in the Netherlands are yearly diagnosed with cancer. Pregnant women with cancer are often diagnosed later than non-pregnant women because symptoms of cancer are common during pregnancy and may elude suspicion. We report a patient with gastric carcinoma masquerading as hyperemesis gravidarum.
Case Description:
A 39-year-old pregnant woman was admitted at 25 weeks' gestation for the evaluation of persistent nausea, vomiting and weight loss (29 kg) since the beginning of her pregnancy. A presumptive diagnosis of hyperemesis gravidarum was made. Endoscopic examination was not performed. At 28 weeks' gestation caesarean was performed due to fetal distress and revealed a gastric tumour with abnormalities of the omentum. Microscopic examination of the omentum and placental specimen demonstrated poorly differentiated adenocarcinoma cells.
Conclusion:
This case illustrates that endoscopic examination should be conducted in pregnant patients presenting with persistent gastrointestinal symptoms for the differential diagnosis of hyperemesis gravidarum.
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