Rectal cancer in pregnancy: a diagnostic and therapeutic challenge

Monireh Toosi; Leila Moaddabshoar; Seyed Ali Malek-Hosseini; Mohammad Reza Sasani; Maral Mokhtari; Mohammad Mohammadianpanah

doi:10.1016/j.jnci.2014.03.003

Rectal cancer in pregnancy: a diagnostic and therapeutic challenge

J Egypt Natl Canc Inst. 2014 Sep;26(3):175-9. doi: 10.1016/j.jnci.2014.03.003. Epub 2014 Apr 13.

Authors

Monireh Toosi¹, Leila Moaddabshoar², Seyed Ali Malek-Hosseini³, Mohammad Reza Sasani⁴, Maral Mokhtari⁵, Mohammad Mohammadianpanah⁶

Affiliations

¹ Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
² Student Research Committee, Resident of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Organ Transplant Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
⁵ Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.
⁶ Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: mohpanah@sums.ac.ir.

PMID: 25150133
DOI: 10.1016/j.jnci.2014.03.003

Abstract

Introduction: The occurrence of colorectal cancer during pregnancy is rare and is associated with diagnostic and therapeutic challenges. Herein, we report such a case of rectal cancer in pregnancy and review the literature.

Case report: A 31-year-old multiparous, pregnant woman, in the 20th week of gestation, presented with rectal bleeding progressing to spasmodic abdominal pain and right flank vague pain. A flexible rectosigmoidoscopy showed a large ulcerative mass located in the rectosigmoid junction, 15 cm away from anal verge. Imaging studies and biopsy proved it to be rectal adenocarcinoma with single liver metastasis. The patient's pregnancy was terminated and neoadjuvant therapy followed by curative surgery was performed. She is currently receiving adjuvant systemic therapy to eradicate potential micrometastatic disease.

Conclusion: This case suggests that colorectal cancer can mimic the signs and the symptoms of pregnancy and tends to present at an advanced stage in pregnant women.

Keywords: Diagnosis; Pregnancy; Prognosis; Rectal cancer; Treatment.

Publication types

Case Reports
Review

MeSH terms

Adult
Biopsy
Female
Humans
Liver Neoplasms / secondary
Pregnancy
Pregnancy Complications, Neoplastic*
Rectal Neoplasms / diagnosis*
Rectal Neoplasms / pathology
Rectal Neoplasms / therapy*
Tomography, X-Ray Computed
Treatment Outcome