Folk John J, Curioca Jazniya, Nosovitch John T, Silverman Robert K
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.
J Reprod Med. 2004 May;49(5):395-7.
Cancer is an uncommon diagnosis during pregnancy. Advanced disease is unusual; metastasis to the placenta is exceptionally rare. Primary cancers that have been reported to produce placental metastasis include melanoma, breast, hematologic and lung.
A 41-year-old, Caucasian woman, para 4014, at 35 4/7 weeks' gestational age with a singleton pregnancy, presented with weight loss, nausea, vomiting, diarrhea and a nonproductive cough. A detailed evaluation revealed widely metastatic disease with a suspected lung origin. Biopsy of a supraclavicular lymph node revealed poorly differentiated large cell adenocarcinoma. Due to the patient's rapidly deteriorating condition and suspected asymmetric intrauterine growth restriction, induction of labor was undertaken. A female infant, Apgar scores 8 and 9, weight 1,885 g, was delivered vaginally. Pathologic evaluation of the placenta revealed metastatic poorly differentiated large cell adenocarcinoma within the intravillous spaces. The placental tumor appeared to be identical to the tumor identified on the lymph node biopsy. The patient's condition continued to deteriorate, and she died a few weeks after the delivery. The infant was doing well 6 months after birth.
Placental metastasis is a rare complication among women with widely metastatic large cell adenocarcinoma of the lung. Vaginal delivery can be successful for seriously compromised patients with widespread malignant disease.
癌症在孕期是一种不常见的诊断。晚期疾病并不常见；转移至胎盘极为罕见。据报道可发生胎盘转移的原发性癌症包括黑色素瘤、乳腺癌、血液系统肿瘤和肺癌。
一名41岁的白种女性，孕4产1，妊娠35 4/7周，单胎妊娠，出现体重减轻、恶心、呕吐、腹泻及干咳。详细评估显示为广泛转移的疾病，怀疑起源于肺部。锁骨上淋巴结活检显示为低分化大细胞腺癌。由于患者病情迅速恶化且怀疑存在不对称性胎儿宫内生长受限，遂进行引产。一名女婴经阴道分娩，阿氏评分8分和9分，体重1885克。胎盘的病理评估显示绒毛间隙内有转移性低分化大细胞腺癌。胎盘肿瘤似乎与淋巴结活检中发现的肿瘤相同。患者病情持续恶化，分娩几周后死亡。婴儿出生6个月后情况良好。
胎盘转移是广泛转移的肺大细胞腺癌女性患者中的一种罕见并发症。对于患有广泛恶性疾病且病情严重的患者，阴道分娩可能成功。
