Obstet Gynecol Sci.  2019 Sep;62(5):357-361. 10.5468/ogs.2019.62.5.357.

Gastric cancer during pregnancy with placental involvement: case report and review of published works

• Oga S
• Hachisuga
• Hidaka N
• Fujita Y
• Tomonobe H
• Yamamoto H
• Kato K

• KMID: 2456832
• DOI: http://doi.org/10.5468/ogs.2019.62.5.357

Abstract

Gastric cancer involving the placenta during pregnancy is rare; however, we present 1 such case in this report. A 31-year-old Japanese woman was referred at 26 weeks of gestation for the evaluation of a swollen left supraclavicular lymph node. Biopsy revealed poorly differentiated adenocarcinoma, and esophagogastroduodenoscopy with biopsy of the stomach confirmed the diagnosis of gastric cancer. Her epigastric and back pain became more pronounced and her general status worsened, and we performed a cesarean delivery at 29 weeks. Microscopic examination of the placental specimen revealed poorly differentiated adenocarcinoma cells diffused into the intervillous space. Postpartum chemotherapy consisted of S-1 plus oxaliplatin. Unfortunately, this treatment was ineffective, and the patient died 3 months after delivery. The infant did well, without clinical or laboratory manifestations of metastasis. In patients with advanced gastric cancer during pregnancy, it is important to perform a microscopic examination of the placenta to evaluate for metastatic involvement.

Keyword

Gastric cancer; Placental metastasis; Pregnancy; Villous invasion

MeSH Terms

Adenocarcinoma
Adult
Asian Continental Ancestry Group
Back Pain
Biopsy
Diagnosis
Drug Therapy
Endoscopy, Digestive System
Female
Humans
Infant
Lymph Nodes
Neoplasm Metastasis
Placenta
Postpartum Period
Pregnancy*
Stomach
Stomach Neoplasms*

Figure

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  Fig. 1 Histopathological findings in specimens obtained in our patient showing the following: (A) Lymph node. Poorly differentiated adenocarcinoma cells with signet ring cells (arrow head) are observed. Stain: hematoxylin and eosin, scale bar: 100 μm. (B) Placental specimen. Carcinoma cells (black arrow) invading the intervillous space without invasion of the villi (white arrow) can be observed. Stain: hematoxylin and eosin, scale bar: 1 mm. Squares indicate that the same lesion is pictured.

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