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29 岁 G3P2 患者在单侧肺切除术和全身化疗治疗肺癌后短期内成功妊娠:病例报告。

Successful Pregnancy in a 29-Year-Old G3P2 Shortly After Unilateral Pneumonectomy and Systemic Chemotherapy for Lung Cancer: A Case Report.

机构信息

Department of Obstetrics and Gynecology, Maternity and Children Hospital, King Salman Medical City, Madinah, Saudi Arabia.

Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.

出版信息

Am J Case Rep. 2023 Mar 12;24:e939227. doi: 10.12659/AJCR.939227.

DOI:10.12659/AJCR.939227
PMID:36906799
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10018441/
Abstract

BACKGROUND The incidence of tumors during pregnancy, generally, is very uncommon. The incidence of lung cancer during pregnancy, specifically, is exceedingly rare. Several investigations have documented favorable maternal-fetal outcomes for later pregnancies after pneumonectomy due to non-cancer-related causes (mostly progressive pulmonary tuberculosis). However, very little is known about maternal-fetal outcomes for future conceptions after pneumonectomy due to cancer-related causes and subsequent chemotherapy cycles. This is an important knowledge gap in the literature that needs to be filled. CASE REPORT A 29-year-old woman (non-smoker) had adenocarcinoma of the left lung, which was discovered during her pregnancy at 28 weeks of gestation. She underwent an urgent lower-segment transverse cesarean section at 30 weeks and subsequently underwent unilateral pneumonectomy and then completed her planned adjuvant chemotherapy. The patient was incidentally found to be pregnant at 11 weeks of gestation (roughly 5 months after the completion of her adjuvant chemotherapy cycles). Hence, the conception was estimated to have happened roughly 2 months after the completion of her chemotherapy cycles. A multidisciplinary team was formed and it was decided to keep her pregnancy as there was no clear medical reason to terminate it. The pregnancy was carried out to term gestation at 37+4 weeks with close monitoring, and she delivered a healthy baby via lower-segment transverse cesarean section. CONCLUSIONS Successful pregnancy after unilateral pneumonectomy and adjuvant systematic chemotherapy is rarely reported. The maternal-fetal outcomes after unilateral pneumonectomy and systematic chemotherapy need expertise and a multidisciplinary approach to prevent complications.

摘要

背景

怀孕期间肿瘤的发病率通常非常低。具体来说,怀孕期间肺癌的发病率极为罕见。有几项研究记录了因非癌症相关原因(主要是进展性肺结核)行肺切除术后再次妊娠的母婴结局良好。然而,对于因癌症相关原因和随后的化疗周期而行肺切除术后再次妊娠的母婴结局,知之甚少。这是文献中一个重要的知识空白,需要填补。

病例报告

一位 29 岁的女性(非吸烟者)患有左肺癌,在怀孕 28 周时被发现。她在 30 周时紧急进行了下段横剖宫产,随后进行了单侧肺切除术,并完成了计划的辅助化疗。患者在妊娠 11 周时意外发现怀孕(大致在辅助化疗周期结束后 5 个月)。因此,估计受孕发生在化疗周期结束后大约 2 个月。成立了一个多学科团队,决定保留妊娠,因为没有明确的医学理由终止妊娠。在密切监测下,妊娠足月(37+4 周),通过下段横剖宫产娩出一名健康婴儿。

结论

单侧肺切除术后和辅助系统化疗后成功妊娠的报道很少见。单侧肺切除术后和系统化疗后的母婴结局需要专业知识和多学科方法来预防并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e5/10018441/8b9183cedb6f/amjcaserep-24-e939227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e5/10018441/8b9183cedb6f/amjcaserep-24-e939227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e5/10018441/8b9183cedb6f/amjcaserep-24-e939227-g001.jpg

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