LUNG-CANCER IN PREGNANCY - REPORT OF 2 CASES

Lung cancer during pregnancy is rare, although the number of case repo rts has been increasing in recent years. Herein, we describe two cases of lung carcinoma complicating pregnancy with different presentations and outcomes, and review the relevant literature. The first case invo lved a 31-year-old patient with squamous cell carcinoma with multiple bone metastases. The initial symptoms were productive cough and dyspne a on exertion during the second trimester of pregnancy, to which the p atient paid little attention. Chemoradiation was started 1 month postp artum, soon after the diagnosis was made, but with little response. Sh e died at home several days after palliative radiotherapy. The second case involved a 34-year-old patient with poorly differentiated lung ca rcinoma with brain metastasis. Left hemiparesis had developed initiall y during the third trimester. She underwent excision of the metastatic blain tumor and received radiotherapy to the left lung tumor and brai n. The patient is still alive after a follow-up period of more than 1 year. Delayed diagnosis may be the main problem in the management of l ung cancer during pregnancy, because of misinterpretation of common re spiratory symptoms and physicians' reluctance to use radiologic imagin g studies owing to concerns over the safety of the fetus. Thus, we sug gest chest radiographs with abdominal lead shielding for pregnant pati ents with protracted cough and hemoptysis. Treatment of unresectable l ung cancer during pregnancy generally consisted of radiation therapy w ith or without chemotherapy in previous reports, but the optimal thera py is still unknown, owing to inadequate case numbers and insufficient follow-up data.