An unusual case of maternal death

A 21-year-old primigravid patient presented at 16 weeks gestation with rectal pain. She developed peritonitis at 36 weeks gestation. At laparotomy a very inflamed right fallopian tube and ovary was removed together with a healthy looking appendix. Premature labour occurred two days later with delivery of a stillborn infant. Her general condition deteriorated. On rectal biopsy a mucin secreting carcinoma, probably of secondary origin, was found. Shortly before her death a poorly differentiated adenocarcinoma of the breast was diagnosed.