Miller Keith, Zawislak Agnes, Gannon Caroline, Millar David, Loughrey Maurice B
Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland.
Pediatr Dev Pathol. 2012 May-Jun;15(3):237-9. doi: 10.2350/11-08-1074-CR.1. Epub 2012 Feb 17.
The incidence of maternal cancer during pregnancy is low, and metastatic disease involving the placenta is rare. We present a case of rapidly progressive and fatal gastric carcinoma presenting during pregnancy, with spread to the maternal blood space within the placenta but no chorionic villous invasion and no evidence of fetal transmission at the time of delivery or on 12-month follow up. To the best of our knowledge, there have been only 5 previous single case reports of gastric carcinoma metastatic to the placenta. This case highlights the need for clinical vigilance against dismissing gastrointestinal symptoms as pregnancy related and for pathologists to carefully examine the placenta in the setting of maternal malignancy. When placental metastases are present but with no villous invasion, the risk of fetal metastasis may be extremely low, even in the setting of aggressive, terminal malignancy in the mother.
孕期母体癌症的发病率较低，累及胎盘的转移性疾病也很罕见。我们报告一例孕期出现的快速进展且致命的胃癌病例，肿瘤扩散至胎盘内的母体血腔，但未侵犯绒毛膜绒毛，分娩时及产后12个月随访均未发现胎儿传播的证据。据我们所知，此前仅有5例胃癌转移至胎盘的单病例报告。该病例凸显了临床警惕性的必要性，即不能将胃肠道症状一概视为与妊娠相关，同时病理学家在母体恶性肿瘤情况下需仔细检查胎盘。当存在胎盘转移但未侵犯绒毛时，即使母亲患有侵袭性终末期恶性肿瘤，胎儿转移的风险可能也极低。
