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一位待产年轻母亲胆囊恶性肿瘤管理过程中的困惑状态

The State of Perplexity During Management of Gall Bladder Malignancy in an Expectant Young Mother.

作者信息

Rajput Deepak, Gupta Amit, Gupta Sweety, Rai Ankit, Shasheendran Sruthi

机构信息

Department of Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND.

Department of Radiation Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh, IND.

出版信息

Cureus. 2021 Feb 3;13(2):e13099. doi: 10.7759/cureus.13099.

Abstract

During pregnancy, diagnosed cancer causes a major disturbance in the life of a pregnant woman and her family. The advanced stage of illness requiring systemic treatment inevitably leads the treating practitioner, with two lives at risk, into an ethical dilemma. The unborn child can be affected by the application of cancer medication to the mother as it is exposed to fetotoxic drugs. On the other hand, withholding therapy to allow fetal maturity may make the disease of the mother metastatic. Gall bladder carcinoma is often diagnosed as an unresectable disease (metastatic or locally advanced) due to its nonspecific symptomatology and carries the worst prognosis of any gastrointestinal or hepatobiliary neoplasm. We report a case of locally advanced gall bladder cancer (GBC) diagnosed during late pregnancy wherein the mother opted to continue the pregnancy without any intervention. A review of literature has been done to investigate the role of female hormones in a pregnancy complicating GBC with emphasis on management dilemma and the associated pitfalls.

摘要

孕期被诊断出患有癌症会给孕妇及其家庭的生活带来极大困扰。疾病的晚期需要进行全身治疗,这不可避免地使治疗医生陷入伦理困境,因为两条生命都面临风险。未出生的胎儿可能会因母亲使用抗癌药物而受到影响,因为胎儿会接触到对其有毒的药物。另一方面,为了让胎儿成熟而停止治疗可能会使母亲的疾病发生转移。胆囊癌由于其症状不具特异性,常常被诊断为无法切除的疾病(转移性或局部晚期),其预后是所有胃肠道或肝胆肿瘤中最差的。我们报告一例妊娠晚期诊断为局部晚期胆囊癌(GBC)的病例,该病例中母亲选择在不进行任何干预的情况下继续妊娠。我们对文献进行了综述,以研究女性激素在合并GBC的妊娠中的作用,重点关注管理困境及相关陷阱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7e7/7934605/c0f4a17440d6/cureus-0013-00000013099-i01.jpg

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