Pregnancy-preserving and maternal-fetal management in a patient with rare large cell neuroendocrine carcinoma of the uterine cervix.
10.12122/j.issn.1673-4254.2021.01.01
- Author:
Geyang DAI
1
;
Gaowen CHEN
1
;
Li XIAOXUAN
1
;
Youhong ZHENG
1
;
Yuan WANG
1
;
Xingsong LI
2
;
Li JING
2
;
Jing ZHOU
3
;
Yu XIE
4
;
Yifeng WANG
1
Author Information
1. Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
2. Novogene Bioinformatics Institute, Beijing 100020, China.
3. Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200111, China.
4. Department of Information, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
- Publication Type:Systematic Review
- Keywords:
cancer predisposing genes;
large cell neuroendocrine carcinoma;
maternal-fetal management;
pregnancy- preserving management;
primary gynecologic neuroendocrine tumors
- MeSH:
Adenocarcinoma;
Adult;
Carcinoma, Neuroendocrine/genetics*;
Child;
Female;
Humans;
Infant, Newborn;
Neoplasm Recurrence, Local;
Pregnancy;
Uterine Cervical Neoplasms/genetics*
- From:
Journal of Southern Medical University
2021;41(1):1-9
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the strategy of pregnancy-preserving and maternal- fetal management in patients with primary gynecologic neuroendocrine tumors (gNETs) during pregnancy.
METHODS:We performed whole genome sequencing (WGS) for analyzing maternal and fetal somatic and germline single nucleotide variations (SNVs) and small insertions and deletions (InDels) for a 29-year-old pregnant woman diagnosed with stage IB2 large cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma in the cervix. A systematic literature review was performed to explore the strategies for treatment of such rare histological type while maintaining pregnancy.
RESULTS:Global case analysis of cervical NETs during pregnancy suggested that negative lymph node metastasis and an early FIGO stage were potentially associated with a good prognosis of the patients. In the case presented herein, a pregnancy-preserving strategy was adopted and favorable maternal-fetal outcomes were achieved after neoadjuvant chemotherapy, radical surgery and postoperative systemic chemotherapy. At 35
CONCLUSIONS:Although gNETs in pregnancy are rare and highly risky, pregnancy-preserving managements of gNETs can still be considered and favorable maternalfetal outcomes are possible with proper assessment of the clinical indications and implementation of multimodal treatments. Precise treatment and follow-up strategies based on the results of WGS for risk-reducing intervention of cancer recurrence or occurrence can potentially benefit the patient and the neonate.
