一个具有挑战性的案例:妊娠期结直肠癌

IF 0.2 Q4 PHARMACOLOGY & PHARMACY
Caesar Ahmad Tidel, Syifa Mustika
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摘要

结直肠癌(CRC)发生在年轻女性可导致怀孕期间结直肠癌的发病率增加。怀孕期间结直肠癌的恶性肿瘤发生率估计为1 / 13000。然而,怀孕期间结直肠癌的确切原因尚不完全清楚。诊断和治疗妊娠期结直肠癌是一项重大挑战,因为这些症状可能被正常的妊娠体征和症状所掩盖。病例介绍:42岁孕妇L女士,腹痛,深色肠蠕动史,颈部左侧肿块已存在一年。她在怀孕前和怀孕期间体重减轻了5公斤,以前没有恶性肿瘤史。患者接受了各种诊断程序,包括妊娠超声、腹部超声和结肠镜活检。综合患者病史、体格检查及相关检查,诊断为IV期直肠腺癌,伴肝、肾、淋巴结转移。患者妊娠27-29周,为二胎(G2P1Ab0)。结论:妊娠期结直肠癌给诊断和治疗带来了挑战,因为其体征和症状往往归因于妊娠的正常进展,导致晚期诊断延迟。早期发现、评估和监测非特异性症状是至关重要的,多学科方法对于妊娠期结直肠癌的治疗是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Challenging Case: Colorectal Cancer During Pregnancy
Introduction: Colorectal cancer (CRC) occurring in younger women can lead to an increased incidence of colorectal cancer during pregnancy. The estimated frequency of malignancy during pregnancy with colorectal cancer specifically estimated at 1 in 13,000 pregnancies. However, the exact causes of colorectal cancer during pregnancy are not yet fully understood. Diagnosing and managing colorectal cancer during pregnancy pose significant challenges because the symptoms can be masked by the normal signs and symptoms of pregnancy. Case Pesentation: A 42-year-old pregnant patient, Mrs. L, presented with abdominal pain, a history of dark-colored bowel movements, and a lump on the left side of her neck that had been present for a year. She had also experienced a weight loss of 5 kg both before and during pregnancy, and there was no previous history of malignancy. The patient underwent various diagnostic procedures, including pregnancy ultrasound, abdominal ultrasound, and colonoscopy biopsy. Based on the comprehensive evaluation of the patient's medical history, physical examination, and supporting tests, she was diagnosed with stage IV rectal adenocarcinoma with metastases to the liver, kidney, and lymph nodes. The patient was in her second pregnancy (G2P1Ab0) at 27-29 weeks of gestation. Conclusion: Colorectal cancer during pregnancy poses diagnostic and therapeutic challenges, as the signs and symptoms are often attributed to the normal progression of pregnancy, resulting in delayed diagnosis at an advanced stage. Early detection, evaluation, and monitoring of nonspecific symptoms are crucial, and a multidisciplinary approach is necessary for the management of colorectal cancer during pregnancy.
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