1.Metastatic colon adenocarcinoma in pregnancy
Deverly Rina Villanueva Reyes ; Jemimah T. Cartagena‑Lim ; Mario Reyes Festin
Philippine Journal of Obstetrics and Gynecology 2024;48(2):111-116
Colon cancer in pregnancy is rare. Symptoms are nonspecific; hence, patients are often diagnosed
at an advanced stage with poor prognosis. We present a 40‑year‑old multigravid who had recurrent
severe abdominal pain. She underwent surgeries at 9 and 21 weeks age of gestation with an initial
assessment of ovarian malignancy. Further workup showed metastatic adenocarcinoma to the
pelvis with colonic primary. Chemotherapy was subsequently deferred due to COVID‑19 infection.
She eventually developed partial gut obstruction and underwent bowel diversion with intraoperative
fetal monitoring at 31 weeks age of gestation. Although the fetus developed growth restriction, the
pregnancy was successfully carried to term with a good outcome. Palliative chemotherapy was started
postpartum and she completed eight cycles. Unfortunately, she succumbed to death after 1 year due
to pulmonary metastases. Despite challenges in diagnosis and management, this case shows that
it is possible to have a good outcome in a pregnancy complicated by advanced-stage colon cancer.
2.Recurrent dedifferentiated retroperitoneal liposarcoma complicating pregnancy
Jemimah T. Cartagena‑Lim ; Kristine Therese R. Elises-Molon
Philippine Journal of Obstetrics and Gynecology 2024;48(2):117-123
Retroperitoneal liposarcoma is an uncommon tumor both in the pregnant and nonpregnant state.
Its exact incidence is unknown because of its rarity. Due to its propensity for local recurrence,
prognosis depends on histologic subtype and negative margins of resection. Surgery remains the
mainstay of treatment, and timing is critical in terms of finding a surgically resectable lesion while
balancing fetal risks. This report describes tumor recurrence in a pregnancy with a prior history of
surgery for an atypical lipomatous tumor presenting as a retroperitoneal mass. After discussion with
the multidisciplinary team, as well as with the patient’s consent, the plan was to defer surgery until
34 weeks, followed by scheduled tumor removal 2 weeks postpartum. She delivered abdominally
to a baby girl with a good outcome. Histopathology showed dedifferentiated liposarcoma with a
positive tumor margin. The patient has survived at 6-month follow-up and completed four cycles
of chemotherapy with doxorubicin, ifosfamide, and mesna. However, surveillance imaging again
showed tumor recurrence.
Liposarcoma