Neves I, Mota P C, Hespanhol V P
Serviço de Pneumologia, Centro Hospitalar de São João, EPE - Porto, Porto, Portugal.
Serviço de Pneumologia, Centro Hospitalar de São João, EPE - Porto, Porto, Portugal; Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Rev Port Pneumol. 2014 Jan-Feb;20(1):46-9. doi: 10.1016/j.rppneu.2013.06.005. Epub 2013 Jul 31.
The incidence of pregnancy-associated cancer is relatively low, complicating only 0.02-0.1% of all pregnancies. The authors describe a case of a 36-year-old woman, a light smoker, who was admitted to the hospital at 27 weeks of pregnancy, with respiratory symptoms since second trimester. Chest-X ray showed total left lung opacity with contralateral mediastinal deviation, suggestive of pleural effusion, and the pleural biopsy revealed invasion by lung adenocarcinoma. EGFR mutation test was negative. After a multidisciplinary meeting, it was decided to start fetal lung maturation and cesarean section at 29 weeks gestation. The patient received two lines of chemotherapy and bone metastasis radiotherapy, but there was progression of the disease. An EML4-ALK translocation was identified in an additional genetic test. Crizotinib 250mg BID was started. The patient showed a progression-free survival of 9 months and died 19 months after lung adenocarcinoma was diagnosed.
妊娠相关癌症的发病率相对较低，仅占所有妊娠的0.02 - 0.1%。作者描述了一例36岁的轻度吸烟者，在妊娠27周时因自孕中期以来出现呼吸道症状入院。胸部X光显示左肺完全不透明，伴有对侧纵隔移位，提示胸腔积液，胸膜活检显示为肺腺癌浸润。表皮生长因子受体（EGFR）突变检测为阴性。经过多学科会诊后，决定在妊娠29周时开始促进胎儿肺成熟并进行剖宫产。患者接受了两线化疗和骨转移放疗，但疾病仍进展。在进一步的基因检测中发现了棘皮动物微管相关蛋白样4（EML4）-间变性淋巴瘤激酶（ALK）易位。开始使用克唑替尼250mg每日两次。患者在肺腺癌诊断后无进展生存期为9个月，19个月后死亡。
