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.