MyMedR

Navigating an unexpected diagnosis - experience of a tertiary referral centre with two cases of intraplacental choriocarcinoma

Lim CCW, Punjabi LS, Bhatia A, Ng QJ, Jevon GP, Aggarwal IM

Malays J Pathol, 2024 Apr;46(1):91-94.

PMID: 38682848

Intraplacental choriocarcinoma is a rare tumour, with approximately 62 reported cases. It may manifest as a spectrum of disease ranging from an incidental lesion diagnosed on routine placental examination to disseminated maternal and/or neonatal disease. In this case series, we presented two rare cases of intraplacental choriocarcinoma with extremely varied clinical presentations. The extremely varied clinical presentations of both patients described in the case series complicated the process of arriving at the diagnosis. In both cases, subsequent investigations showed no maternal or neonatal metastasis, and maternal serum beta-hCG levels downtrended with conservative management. We aim to highlight the importance of performing a detailed physical examination and evaluation of the patient and multidisciplinary management with oncology opinion. A detailed examination of the placenta should also be considered when faced with obstetric complications so that early diagnosis and the required management can be executed in a prompt fashion.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology

Fulltext Nasal septal haemangioma in pregnancy

Noorizan Y, Salina H

Med J Malaysia, 2010 Mar;65(1):70-1.

PMID: 21265255 MyJurnal

A pregnant lady in her third trimester presented with a rapidly growing right-sided nasal mass associated with epistaxis and nasal obstruction for two months. Examination showed a non tender, protruding mass completely occluding her right nostril. Wide surgical excision was done under local anaesthesia. Histopathology revealed capillary haemangioma. In a gravid patient with a rapidly growing intranasal lesion, capillary haemangioma should be considered as a differential diagnosis. Due to the rapidity of growth, presentation with epistaxis and its macroscopic appearance which often mimics malignancy; histologic confirmation is crucial.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology*

Angiosarcoma of the breast complicating pregnancy

Kaur G

Malays J Pathol, 1998 Jun;20(1):41-4.

PMID: 10879263

A 32-year-old pregnant lady presented with a rapidly enlarging right breast mass. A fine needle aspiration was suggestive of a malignant phylloides tumour. However histopathological examination after mastectomy revealed a moderately differentiated angiosarcoma. The histopathological and cytological features of this rare tumour together with the diagnostic pitfalls are discussed.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology*

Phyllodes Tumor of the Breast during Pregnancy and Lactation; A Systematic Review

Alipour S, Eskandari A, Johar FM, Furuya S

Arch Iran Med, 2020 07 01;23(7):488-497.

PMID: 32657600 DOI: 10.34172/aim.2020.46

BACKGROUND: Phyllodes tumor (PT) is a rare tumor of the breast, which may occur during pregnancy or lactation. Several studies have reviewed and discussed PT occurring in pregnancy, gathering up to 14 patients. We performed a thorough systematic review of the literature in an attempt to find all reported cases, and identify their common characteristics.

METHODS: We searched Google scholar, PubMed, Ovid Medline, Scopus and ClinicalTrials.gov with several relevant combinations of keywords, looking for texts or abstracts without any date or language limitations, but using only English keywords. The existing literature only consisted of case reports and series; therefore any paper including one or several cases of PT presenting during pregnancy or breastfeeding was recognized as eligible. Articles with vague description of the tumor which made the diagnosis uncertain, and those lacking data about the tumor and management data were excluded. We contacted authors for more details in cases with incomplete information.

RESULTS: After excluding those with very deficient data, we included 37 studies, counting 43 cases. The mean age of the patients was 31 years (21-43 years). Some features were different from usual PT: bilaterality (16.2%), large size (14.2 ± 8.6 cm), rapid enlargement (79.5%), and rate of malignancy (60.5%).

CONCLUSION: Our findings show high rates of bilaterality, large size, rapid growth, and malignant pathology in the reported gestational PTs.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology

Incidence of acute atherosis in complete molar pregnancy

Hayati AR, Azizah A, Wahidah A

Malays J Pathol, 1998 Dec;20(2):113-4.

PMID: 10879273

A clinicohistological study of acute atherosis in molar pregnancy was undertaken. Maternal decidual vessels in currettage samples of 38 histologically confirmed complete hydatidiform moles were examined histologically for acute atherosis, recognised as fibrinoid necrosis of the smooth muscle wall with a perivascular mononuclear cell infiltrate, with or without lipophages. Acute atherosis was detected in eight of 38 cases, an incidence of 18.4%. All the patients were normotensive. The significance of acute atherosis in molar pregnancy remains to be clarified.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology*

Surgical management of early invasive cancer of the cervix associated with pregnancy

Sivanesaratnam V, Jayalakshmi P, Loo C

Gynecol Oncol, 1993 Jan;48(1):68-75.

PMID: 8423024

The simultaneous occurrence of carcinoma of the cervix in pregnancy is uncommon. In a prospective study of 397 patients undergoing type III radical hysterectomy for early invasive cancer of the cervix, 18 were pregnant at the time of surgery; 4 of these were operated after delivery elsewhere. Two others had a type I extrafascial hysterectomy. The incidence was 1 in 4077 deliveries. The clinical and histological characteristics of these patients are presented. Routine speculum examination and cervical cytology in all pregnant patients early in pregnancy are vital for early diagnosis. Bleeding in pregnancy should not automatically be assumed to be caused by pregnancy-related conditions. The strategies in surgical management are discussed. Radical hysterectomy in pregnancy is safe. No major complications were encountered; the mean blood loss was 1.4 liters. The incidence of pelvic node metastases was similar to that seen in nonpregnant patients. The overall 5-year survival rate was 77.7%. Of the 4 patients who died, 3 presented in the puerperium; all succumbed within 27 months. Poor histological prognostic features contributed to the significantly poorer survival in the puerperal patients (P = 0.0445). The 5-year survival in those presenting during the antepartum period (92.8%) was, however, similar to that in the nonpregnant patients. Metastases to the placenta or fetus were not encountered.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology

Fulltext Maternal melanoma with placental metastasis

Shuhaila A, Rohaizak M, Phang KS, Mahdy ZA

Singapore Med J, 2008 Mar;49(3):e71-2.

PMID: 18362990

A 40-year-old woman, a grand multipara with uncertain gestation, presented with severe, prolonged diarrhoea. She was previously diagnosed to have melanoma. Examination revealed gross ascites with hepatosplenomegaly and uterus corresponding to 29 weeks gestation. An emergency caesarean section confirmed widespread metastases to the ovaries, mesentery and placenta. A viable male foetus was delivered with features of intrauterine growth restriction. The baby survived, but the mother died a week later. This case highlights the importance of thoroughly assessing placentas and babies of patients with melanoma for metastases.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology

Successful pregnancy with epidermal growth factor receptor tyrosine kinase inhibitor treatment of metastatic lung adenocarcinoma presenting with respiratory failure

Lee CH, Liam CK, Pang YK, Chua KT, Lim BK, Lai NL

Lung Cancer, 2011 Nov;74(2):349-51.

PMID: 21920622 DOI: 10.1016/j.lungcan.2011.08.008

We report a woman presenting with respiratory failure due to a right-sided pleural effusion, lung metastases and lymphangitis carcinomatosis from advanced lung adenocarcinoma in the third trimester of pregnancy, who showed good response to EGFR tyrosine kinase inhibitor.

Matched MeSH terms: Pregnancy Complications, Neoplastic/pathology

Displaying all 8 publications