Neuroendocrine carcinoma of unknown origin diagnosed in pregnancy

Cancer in pregnancy (CIP) is a complex diagnosis that requires the clinician to balance obstetric and oncologic considerations. We present a rare case of neuroendocrine carcinoma of unknown primary site diagnosed in pregnancy to highlight the challenges of CIP management. A woman in her 30s with a history of hepatitis B presented with abdominal pain at 30 weeks and 3 days gestation. Liver ultrasound revealed enlargement of pre-existing liver lesions, concerning for hepatocellular carcinoma. After urgent multidisciplinary input, a consensus decision was made for planned caesarean delivery at 31 weeks prior to further investigation. Biopsy and metastatic evaluation revealed a metastatic neuroendocrine carcinoma of unknown origin. The patient commenced palliative chemotherapy at 3 weeks post partum. Prompt multidisciplinary decision-making allowed timely diagnosis and initiation of treatment, with minimal compromise to perinatal outcomes. This case highlights the multidisciplinary team as the cornerstone of CIP management and emphasises the need for personalised treatment.