Takai Hiroshi, Kondoh Eiji, Sato Yukiyasu, Kakui Kazuyo, Tatsumi Keiji, Konishi Ikuo
Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
J Obstet Gynaecol Res. 2011 Nov;37(11):1717-9. doi: 10.1111/j.1447-0756.2011.01561.x. Epub 2011 Jun 16.
Gastric cancer during pregnancy is rare and the outcome is generally poor. A 36-year-old woman in the 28th week of gestation was complicated with disseminated intravascular coagulation (DIC), and she was diagnosed with gastric cancer with bone marrow metastasis. Cesarean delivery followed by sequential methotrexate (100 mg/m2) and 5-fluorouracil (600 mg/m2) chemotherapy was conducted. DIC was successfully managed with blood transfusion and chemotherapy. She has received chemotherapy in the outpatient clinic. This report is the second case of a pregnant woman with DIC as the initial manifestation of advanced gastric cancer. Prompt diagnosis and chemotherapy increases the chances of a relatively favorable outcome even in advanced gastric cancer presenting with DIC due to bone marrow involvement.
妊娠期胃癌罕见,预后通常较差。一名36岁处于孕28周的女性并发弥散性血管内凝血(DIC),被诊断为胃癌伴骨髓转移。进行了剖宫产,随后序贯甲氨蝶呤(100mg/m²)和5-氟尿嘧啶(600mg/m²)化疗。通过输血和化疗成功控制了DIC。她在门诊接受了化疗。本报告是第二例以DIC为晚期胃癌首发表现的孕妇病例。即使对于因骨髓受累而出现DIC的晚期胃癌,及时诊断和化疗也会增加获得相对良好预后的机会。