Disseminated carcinomatosis of the bone marrow from gastric cancer during pregnancy

Clin J Gastroenterol. 2019 Oct;12(5):447-452. doi: 10.1007/s12328-019-00963-1. Epub 2019 Mar 26.

Abstract

Gastric cancer during pregnancy is extremely rare and difficult to diagnose at early stages because of its nature. Furthermore, it is often difficult to determine the appropriate treatment strategy considering both the patient's condition and the effect of the treatment on the fetus. We present a case of a 34-year-old woman with gastric cancer who was 22 weeks pregnant and had multiple liver and bone metastases at the time of diagnosis. The disease progressed to disseminated carcinomatosis of the bone marrow, in which cancer invades and spreads diffusely to the bone marrow and then presents disseminated intravascular coagulation. Fortunately, the selected systematic chemotherapy dramatically reduced the severity of the patient's cancer and she could deliver her baby successfully. There are few reports of disseminated carcinomatosis of the bone marrow from gastric cancer during pregnancy. Even in such an oncological emergency, prompt chemotherapy saved the mother's life and enabled safe delivery of the fetus.

Keywords: Chemotherapy; Disseminated carcinomatosis of the bone marrow; Gastric cancer; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / secondary*
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Neoplasms / complications
  • Bone Marrow Neoplasms / diagnostic imaging
  • Bone Marrow Neoplasms / drug therapy
  • Bone Marrow Neoplasms / secondary*
  • Disseminated Intravascular Coagulation / diagnostic imaging
  • Disseminated Intravascular Coagulation / drug therapy
  • Disseminated Intravascular Coagulation / etiology*
  • Fatal Outcome
  • Female
  • Gastroscopy
  • Humans
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnostic imaging*
  • Pregnancy Complications, Neoplastic / drug therapy
  • Pregnancy Outcome
  • Stomach Neoplasms / complications*
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / drug therapy