Joe Sandra Marie, Karmali Deepa, Bhende Vishal V
Obstetrics and Gynaecology, Goa Medical College and Hospital, Bambolim, IND.
Paediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND.
Cureus. 2025 May 27;17(5):e84927. doi: 10.7759/cureus.84927. eCollection 2025 May.
Sinonasal malignancies during pregnancy present unique diagnostic and therapeutic challenges due to their rarity and nonspecific clinical presentation. This case describes a 28-year-old primigravida patient at 32 weeks of gestation, who presented with left-sided nasal obstruction, epistaxis, and facial swelling. Clinical evaluation, imaging, and histopathology confirmed adenoid cystic carcinoma of the left maxillary sinus. Given the advanced disease stage, a multidisciplinary team opted for conservative management until fetal viability was ensured. At 35 weeks and 3 days of gestation, the patient underwent an emergency cesarean section, delivering a healthy neonate. Postpartum, she underwent left total maxillectomy, followed by adjuvant radiotherapy and five cycles of intravenous cisplatin chemotherapy. Long-term follow-up demonstrated stable disease, with minor speech difficulties and adequate oral intake. This case highlights the importance of early recognition, individualized treatment strategies, and multidisciplinary collaboration in managing malignancies during pregnancy, while balancing maternal prognosis and fetal safety. Further research is needed to establish standardized treatment guidelines for rare malignancies in pregnancy.
孕期鼻窦恶性肿瘤因其罕见性和非特异性临床表现而带来独特的诊断和治疗挑战。本病例描述了一名妊娠32周的28岁初产妇，出现左侧鼻塞、鼻出血和面部肿胀。临床评估、影像学检查和组织病理学检查确诊为左上颌窦腺样囊性癌。鉴于疾病分期较晚，多学科团队选择采取保守治疗，直至确保胎儿具有生存能力。妊娠35周零3天时，患者接受了急诊剖宫产，产下一名健康的新生儿。产后，她接受了左上颌骨全切术，随后进行辅助放疗和五个周期的静脉顺铂化疗。长期随访显示病情稳定，有轻微言语困难且经口摄入充足。本病例强调了在孕期管理恶性肿瘤时，早期识别、个体化治疗策略和多学科协作的重要性，同时要平衡母体预后和胎儿安全。需要进一步研究以建立孕期罕见恶性肿瘤的标准化治疗指南。
