Oga Seiya, Hachisuga Masahiro, Hidaka Nobuhiro, Fujita Yasuyuki, Tomonobe Hiroshi, Yamamoto Hidetaka, Kato Kiyoko
Department of Obstetrics and Gynecology, Pathological Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Anatomic Pathology, Pathological Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Obstet Gynecol Sci. 2019 Sep;62(5):357-361. doi: 10.5468/ogs.2019.62.5.357. Epub 2019 Jul 22.
Gastric cancer involving the placenta during pregnancy is rare; however, we present 1 such case in this report. A 31-year-old Japanese woman was referred at 26 weeks of gestation for the evaluation of a swollen left supraclavicular lymph node. Biopsy revealed poorly differentiated adenocarcinoma, and esophagogastroduodenoscopy with biopsy of the stomach confirmed the diagnosis of gastric cancer. Her epigastric and back pain became more pronounced and her general status worsened, and we performed a cesarean delivery at 29 weeks. Microscopic examination of the placental specimen revealed poorly differentiated adenocarcinoma cells diffused into the intervillous space. Postpartum chemotherapy consisted of S-1 plus oxaliplatin. Unfortunately, this treatment was ineffective, and the patient died 3 months after delivery. The infant did well, without clinical or laboratory manifestations of metastasis. In patients with advanced gastric cancer during pregnancy, it is important to perform a microscopic examination of the placenta to evaluate for metastatic involvement.
妊娠期胃癌累及胎盘的情况罕见;然而,我们在本报告中呈现1例此类病例。一名31岁的日本女性在妊娠26周时因左侧锁骨上淋巴结肿大前来就诊。活检显示为低分化腺癌,食管胃十二指肠镜检查及胃活检确诊为胃癌。她的上腹部和背部疼痛加剧,全身状况恶化,我们在29周时进行了剖宫产。胎盘标本的显微镜检查显示低分化腺癌细胞扩散至绒毛间隙。产后化疗采用S-1加奥沙利铂。不幸的是,该治疗无效,患者在分娩后3个月死亡。婴儿情况良好,无转移的临床或实验室表现。对于妊娠期晚期胃癌患者,对胎盘进行显微镜检查以评估是否存在转移累及很重要。