Kleijn T G, Scholten I, Knol H M, Zwart J J, Hoogland A M
Universitair Medisch Centrum Groningen, afd. Pathologie, Groningen.
Contact: T. G. Kleijn (
Ned Tijdschr Geneeskd. 2022 Jun 15;166:D6681.
About 200 pregnant women in the Netherlands are yearly diagnosed with cancer. Pregnant women with cancer are often diagnosed later than non-pregnant women because symptoms of cancer are common during pregnancy and may elude suspicion. We report a patient with gastric carcinoma masquerading as hyperemesis gravidarum.
A 39-year-old pregnant woman was admitted at 25 weeks' gestation for the evaluation of persistent nausea, vomiting and weight loss (29 kg) since the beginning of her pregnancy. A presumptive diagnosis of hyperemesis gravidarum was made. Endoscopic examination was not performed. At 28 weeks' gestation caesarean was performed due to fetal distress and revealed a gastric tumour with abnormalities of the omentum. Microscopic examination of the omentum and placental specimen demonstrated poorly differentiated adenocarcinoma cells.
This case illustrates that endoscopic examination should be conducted in pregnant patients presenting with persistent gastrointestinal symptoms for the differential diagnosis of hyperemesis gravidarum.
荷兰每年约有200名孕妇被诊断出患有癌症。患有癌症的孕妇往往比非孕妇诊断得晚，因为癌症症状在孕期很常见，可能会被忽视。我们报告一例伪装成妊娠剧吐的胃癌患者。
一名39岁孕妇在妊娠25周时因自怀孕开始就持续出现恶心、呕吐和体重减轻（29千克）而入院。初步诊断为妊娠剧吐。未进行内镜检查。妊娠28周时因胎儿窘迫行剖宫产，发现胃部肿瘤伴大网膜异常。大网膜和胎盘标本的显微镜检查显示为低分化腺癌细胞。
该病例表明，对于出现持续性胃肠道症状的孕妇，应进行内镜检查以鉴别诊断妊娠剧吐。
