Colon cancer during pregnancy - A case report

BACKGROUND: The reported incidence of cancer during pregnancy is between 0. 07% and 0.1%. The incidence of colorectal carcinoma in pregnancy was 1 per 13,000 liveborn deliveries during 1981-1989. CASE: A 33-year-old woman, gravida 2, para 1, was admitted at 30 weeks' ges tational age with a history of rectal bleeding and right upper quadrant pai n. Abdominal ultrasound and magnetic resonance imaging revealed a mass loca ted on the posterior part of the right liver and a fetus with vertex presen tation. Primary cesarean section and a right hemicolectomy and wedge biopsy from the metastatic lesion on the right side of the liver at 34 weeks' ges tation was performed. Histologic examination confirmed serosal and lymph no de invasion of moderately differentiated mucous-secreting adenocarcinoma of the cecum and adenocarcinoma metastatic to the liver. The patient received systemic chemotherapy. CONCLUSION: Only 1 of 41 cases of colon cancer during pregnancy above the p eritoneal reflection has been reported to be localized to the cecum. Our ca se is the second such one. Women with colorectal carcinoma during pregnancy usually have a poor prognosis, which may be attributable to younger age an d delay in diagnosis since the initial symptoms often are presumed attribut ed to normal pregnancy, as in this case.