Yildiz Mustafa, Akgun Yesim, Ozer Hale, Mihmanli Veli
Health Sciences University Okmeydani Training and Research Hospital, Obstetrics and Gynecology Clinic, Istanbul, Turkey.
BMC Gastroenterol. 2020 Feb 12;20(1):33. doi: 10.1186/s12876-020-1184-9.
Gastrointestinal system (GIS) malignancy with pregnancy is a very rare condition and is not common outside Japan. The incidence is between 0.025-0.1% for each pregnancy. GIS malignancies are diagnosed late in pregnancy and detected at an advanced stage. The most common cause of this condition is that the symptoms such as vomiting, nausea, loss of appetite and abdominal growth are mistaken with pregnancy and malignancy is overlooked. Especially in the second trimester, symptoms such as nausea and vomiting, weight loss, melena, hematemesis and deep anemia should suggest malignancy. Upper GIS endoscopy and colonoscopy are the recommended screening methods in these patients, especially in the third trimester.
We present a rare case presenting to our emergency room with the complaint of bloody vomiting, at the 36th week of gestation with a live singleton pregnancy, and receiving the diagnosis of undifferentiated gastric carcinoma from the biopsy taken from the ulcerated lesion on the stomach cardia, with upper GIS endoscopy performed due to deep anemia, who underwent simultaneous cesarean section and subtotal gastrectomy.
Gastrointestinal system (GIS) malignancy with pregnancy is a very rare condition, but it should be considered when symptoms such as nausea and vomiting, weight loss, melena, hematemesis and deep anemia occur, especially in the second trimester, and endoscopic screening should be recommended. Because of the delay in diagnosis of malignancy and the detection in advanced stages, patients should be referred for treatment without delay.
妊娠期胃肠道系统（GIS）恶性肿瘤是一种非常罕见的疾病，在日本以外并不常见。每次妊娠的发病率在0.025%至0.1%之间。GIS恶性肿瘤在妊娠晚期被诊断出来，且多在晚期被发现。造成这种情况的最常见原因是呕吐、恶心、食欲不振和腹部增大等症状被误诊为妊娠，从而忽略了恶性肿瘤。特别是在孕中期，恶心、呕吐、体重减轻、黑便、呕血和重度贫血等症状应提示可能存在恶性肿瘤。上消化道GIS内镜检查和结肠镜检查是这些患者推荐的筛查方法，尤其是在孕晚期。
我们报告一例罕见病例，该患者在妊娠36周时因单胎活产妊娠出现呕血症状前来我院急诊室就诊，因重度贫血进行了上消化道GIS内镜检查，从贲门部溃疡病变处活检诊断为未分化胃癌，随后该患者同时接受了剖宫产和胃次全切除术。
妊娠期胃肠道系统（GIS）恶性肿瘤是一种非常罕见的疾病，但当出现恶心、呕吐、体重减轻、黑便、呕血和重度贫血等症状时，尤其是在孕中期，应考虑到这种疾病，并建议进行内镜筛查。由于恶性肿瘤诊断延迟且多在晚期被发现，患者应及时转诊接受治疗。
