From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, and the Division of Gynecologic Oncology, University of Tennessee-West Clinic, Memphis, Tennessee; and the Divisions of Maternal-Fetal Medicine, Duke University Medical Center, Durham, North Carolina, and Cedars-Sinai Medical Center, Los Angeles, California.
Obstet Gynecol. 2012 Feb;119(2 Pt 2):445-447. doi: 10.1097/AOG.0b013e318236ffcd.
Neuroendocrine carcinoma of the vagina is extremely rare. Treatment options in pregnancy are complex owing to the aggressive tumor type and poor prognosis.
We report the case of a gravid woman diagnosed with stage IVB neuroendocrine carcinoma of the vagina at 16 weeks of gestation. Disease responded to chemotherapy, and pregnancy was continued until onset of preterm labor at 28 5/7 weeks of gestation, with subsequent delivery of a viable fetus. Despite aggressive treatment with chemoradiation postpartum, the patient died of progressive disease 11 months after initial diagnosis.
A multidisciplinary team should review treatment options and potential complications with the patient. Because of the tendency toward early tumor dissemination, the optimal treatment for neuroendocrine carcinoma in pregnancy involves systemic chemotherapy.
阴道神经内分泌癌极为罕见。由于肿瘤侵袭性强、预后差,妊娠患者的治疗选择较为复杂。
我们报告了一例妊娠 16 周时诊断为 IVB 期阴道神经内分泌癌的孕妇病例。该患者的疾病对化疗有反应,妊娠得以继续,直至 28 周 5/7 月时发生早产,随后分娩出一个存活的胎儿。尽管在产后进行了积极的化疗和放疗,该患者在初始诊断后 11 个月仍因疾病进展而死亡。
多学科团队应与患者一起审查治疗选择和潜在并发症。由于肿瘤有早期播散的倾向,妊娠期间神经内分泌癌的最佳治疗方法是全身化疗。