The Baby Bump and Malignant Lump: A Case Report of a Pregnant Patient with Pelvic Sarcoma

Original Article | Volume 6 | Issue 2 | JBST May-August 2020 | Page 25-27 | Daniela Kristina D. Carolino, Mary Rose C. Gonzales, Richard S. Rotor. DOI: 10.13107/jbst.2020.v06i02.28

Author: Daniela Kristina D. Carolino[1], Mary Rose C. Gonzales[1], Richard S. Rotor[2]

[1]Department of Orthopaedics, Institute of Orthopedics and Sports Medicine, St. Luke’s Medical Center, Quezon City, Metro Manila, Philippines.
[2]Department of Musculoskeletal tumors, Institute of Orthopedics and Sports Medicine, St. Luke’s Medical Center, Quezon City, Metro Manila, Philippines.

Address of Correspondence
Dr. Daniela Kristina D. Carolino, 279 E. Rodriguez Sr. Ave, Quezon City 1112 Metro Manila.
E-mail: dkdcarolino@gmail.com


Abstract

Purpose: The occurrence of a malignancy during the course of pregnancy is uncommon but devastating. Due to the relative rarity of the condition, guidelines for management are largely based on small retrospective studies or case series with limited follow-up. With this case, we aim to discuss the options of management and rationalize the decisions, in which the course of treatment of this patient has proceeded.
Materials and Methods: We describe the clinical presentation of the patient as well as the radiological findings, diagnostic tests, and management during the course of the disease.
Results: A 26-year-old (gravida 2, para 1) Filipino female presented initially with a limp and gradual enlargement of a mass on the right hip while with a single intrauterine pregnancy of 8–9 weeks age of gestation. As the growth the mass continued, the patient sought consult at our institution at 22 weeks gestation and was presented with options for management. The patient opted for conservative treatment with chemotherapy over hemipelvectomy. The neonate was eventually delivered at 35 weeks of gestation and the demise of the patient ensued 2 months postpartum.
Conclusion: The treatment of malignancy in the pregnant patient should be individualized and largely dependent on the decision of the mother, once full disclosure of all options of management, possible risks, and prognosis has been discussed.

Reference:
1. Zagouri F, Dimitrakakis C, Marinopoulos S, Tsigginou A, Dimopoulos MA. Cancer in pregnancy: Disentangling treatment modalities. ESMO Open 2016;1:e000016.
2. Peccatori FA, Azim HA, Orecchia R, Hoekstra HJ, Pavlidis N, Kesic V, et al. Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24 Suppl 6:vi160-70.
3. Postl LK, Gradl G, von Eisenhart-Rothe R, Toepfer A, Pohlig F, Burgkart R, et al. Management of musculoskeletal tumors during pregnancy: A retrospective study. BMC Womens Health 2015;15:48.
4. Zarkavelis G, Petrakis D, Fotopoulos G, Mitrou S, Pavlidisa N. Bone and soft tissue sarcomas during pregnancy: A narrative review of the literature. J Adv Res 2016;7:581-7.
5. Figueiro-Filho EA, Al-Sum H, Parrish J, Wunder JS, Maxwell C. Maternal and fetal outcomes in pregnancies affected by bone and soft tissue tumors. AJP Rep 2018;8:e343-8.
6. Rimawi BH, Green V, Lindsay M. Fetal implications of diagnostic radiation exposure during pregnancy: Evidence-based recommendations. Clin Obstet Gynecol 2016;59:412-8.
7. Kal HB, Struikmans H. Radiotherapy during pregnancy: Fact and fiction. Lancet Oncol 2005;6:328-33.
8. Azim HA, Peccatori FA, Pavlidis N. Treatment of the pregnant mother with cancer: A systemic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: Solid tumors. Cancer Treat Rev 2010;36:101-9.


How to Cite this article: Carolino DKD, Gonzales MRC, Rotor RS | The Baby Bump and Malignant Lump: A Case Report of a Pregnant Patient with Pelvic Sarcoma | Journal of  Bone and Soft Tissue Tumors | May-August 2020; 6(2): 25-27.

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