Merimsky O, Le Cesne A
Department of Medicine, Institut Gustave Roussy, Villejuif, France.
Acta Oncol. 1998;37(7-8):721-7. doi: 10.1080/028418698430106.
The occurrence of cancer in a pregnant woman is a relatively infrequent event. The influence of pregnancy on the initiation, promotion and development of sarcomas is yet unclear. The medical approach is strongly influenced by the type and site of the primary tumor, its growth rate and associated symptoms, and by the need to treat the woman while minimizing fetal toxicity. The medical files of seven pregnant women in whom sarcomas were diagnosed during gestation or 3-4 months after delivery were reviewed. Three had bone sarcomas, and four had soft tissue sarcomas. In five cases there were various reasons for the delayed diagnosis and treatment, including lack of any signs or symptoms during gestation, clinical misdiagnosis, religious attitude and refusal of the patients. Ancillary tests such as magnetic resonance imaging (MRI) and ultrasound, and biopsy, are safe during gestation. Adriamycin, ifosfamide and granisetron were administered in one case during the third trimester, without remarkable toxicity. Whenever a pregnant woman is diagnosed as having a malignant tumor, serious medical, ethical, emotional, religious and philosophical dilemmas arise. The mother's well-being and the risk to the fetus by introducing early diagnostic tests and treatment should be weighed against the risk to the mother and the well-being of the fetus in carrying on an uninterrupted gestation.
孕妇患癌症是相对罕见的事件。妊娠对肉瘤发生、发展和进展的影响尚不清楚。医疗方法很大程度上受原发肿瘤的类型和部位、生长速度及相关症状影响，同时也受在尽量减少胎儿毒性的情况下治疗孕妇的需求影响。回顾了7例在妊娠期或分娩后3 - 4个月被诊断为肉瘤的孕妇的病历。其中3例为骨肉瘤，4例为软组织肉瘤。5例存在诊断和治疗延迟的各种原因，包括妊娠期无任何体征或症状、临床误诊、宗教态度及患者拒绝等。磁共振成像（MRI）和超声等辅助检查以及活检在妊娠期是安全的。1例在孕晚期使用了阿霉素、异环磷酰胺和格拉司琼，未出现明显毒性。一旦孕妇被诊断为患有恶性肿瘤，就会出现严重的医学、伦理、情感、宗教和哲学困境。引入早期诊断检查和治疗对母亲健康及胎儿的风险，应与继续妊娠对母亲的风险及胎儿健康进行权衡。
