Coexistence of Pregnancy and Malignancy

Pavlidis, Nicholas

doi:10.1634/theoncologist.7-6-573

Cited by 316 publications

(286 citation statements)

References 38 publications

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“…Os principais tipos de neoplasia que acometem a mulher na idade reprodutiva são o de mama, o do colo do útero, o linfoma, o câncer de ovário, e o melanoma, embora o câncer durante a gravidez possa surgir a partir de qualquer local 18 .…”

Section: Cad Saúde Pública 2017; 33(3):e00197315unclassified

Mortalidade materna tardia: comparação de dois comitês de mortalidade materna no Brasil

Vega

Soares²,

Nasr³

2017

Cad. Saúde Pública

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Section: Cad Saúde Pública 2017; 33(3):e00197315unclassified

Mortalidade materna tardia: comparação de dois comitês de mortalidade materna no Brasil

Vega

Soares²,

Nasr³

2017

Cad. Saúde Pública

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“…4 The dose to the fetus resulting from standard examinations is lower than 0.01 Gy or, if expressed as cGy, it is equal to 1 cGy. 26 For tomography of the abdomen or pelvis, the dose is 920 mGy or 650 mGy, respectively.…”

Section: Imaging Examinationsmentioning

confidence: 99%

“…Ultrasound can be used to evaluate kidneys and ureters, while magnetic resonance is used to assess tumor size and expansion to adjacent organs (parametrium, vagina, bladder and rectum), and for detection of lymph node metastases. 4,9,28 Since no definitive conclusions regarding deleterious effects in fetuses or embryos exposed to magnetic resonance have been reached, the use of this technique is not recommended during the first trimester of pregnancy.…”

Section: Imaging Examinationsmentioning

confidence: 99%

“…It is followed in frequency by lymphomas, melanoma and thyroid carcinoma. 3,4 About 3% of cases of cervical cancer are diagnosed during pregnancy, 5 and these cases correspond to half of the cases of neoplasia diagnosed during the gestational period. Cervical cancer is the most frequently found malignancy worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…This is due to inspections and cervical cytological tests conducted among women in countries where these examinations are part of routine prenatal care. Several studies have shown that 76% of the lesions diagnosed during pregnancy are in stage IB [4][5][6][7][8][9][10][11] (Table 1). Although diagnoses of cervical cancer during pregnancy are usually made while the disease stage is operable, this time does not always coincide with fetal maturity, thus causing anguish for both the patient and the medical team.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis and treatment of cervical cancer during pregnancy

et al. 2009

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CONTEXT AND OBJECTIVE: One third of all cervical carcinomas occur during the reproductive period. Cervical carcinoma is the second greatest cause of death due to cancer during this phase. The estimated frequency of cervical cancer during pregnancy is one case for every 1,000 to 5,000 pregnancies.The aim here was to provide information about the difficulties in diagnosing and managing cervical neoplasia during pregnancy. MATERIALS:A systematic review of the literature was undertaken through the PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO) databases, using the following words: pregnancy, cervical cancer, diagnosis and management. RESULTS:There was a consensus in the literature regarding diagnosis of cervical carcinoma and management of preneoplastic lesions during pregnancy.However, for management of invasive carcinoma, there was great divergence regarding the gestational age taken as the limit for observation rather than immediate treatment. CONCLUSION:All patients with cytological abnormalities should undergo colposcopy, which will indicate and guide biopsy. Conization is reserved for patients with suspected invasion. High-grade lesions should be monitored during pregnancy and reevaluated after delivery. In cases of invasive carcinoma detected up to the 12 th week of pregnancy, patient treatment is prioritized. Regarding diagnoses made during the second trimester, fetal pulmonary maturity can be awaited, and the use of chemotherapy to stabilize the disease until the time of delivery appears to be viable. RESUMOCONTEXTO E OBJETIVO: Um terço dos carcinomas de colo ocorrem no período reprodutivo, sendo que esta é a segunda causa de morte por câncer nessa fase. A freqüência estimada do carcinoma de colo uterino na gravidez é de um caso para cada 1.000 a 5.000 gestações. O objetivo foi informar sobre as dificuldades frente ao diagnóstico e manejo da neoplasia cervical durante a gravidez. MATERIAIS E MÉTODOS:Revisão sistemática da literatura foi realizada no PubMed, Cochrane, Excerpta Medica (Embase), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO), usando as seguintes palavras: gestação, câncer cervical, diagnóstico e manejo. RESULTADOS:A literatura apresenta consenso quanto ao diagnóstico do carcinoma cervical e a conduta das lesões pré-neoplásicas durante a gestação.No manejo do carcinoma invasor há grande divergência quanto à idade gestacional considerada como limite para a adoção da observação em vez do tratamento imediato.CONCLUSÃO: Toda paciente com citologia alterada deve realizar colposcopia, a qual indicará e a biópsia. A conização é reservada para pacientes com suspeita de invasão. As lesões de alto grau devem ser acompanhadas durante a gestação e reavaliadas após o parto. Em casos de carcinoma invasor em gestantes com até 12 semanas o tratamento da paciente é priorizado. Nos diagnósticos ocorridos no segundo tr...

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Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies

Bianchi

Chudova

Sehnert

et al. 2015

JAMA

365

277

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Understanding the relationship between aneuploidy detection on noninvasive prenatal testing (NIPT) and occult maternal malignancies may explain results that are discordant with the fetal karyotype and improve maternal clinical care.OBJECTIVE To evaluate massively parallel sequencing data for patterns of copy-number variations that might prospectively identify occult maternal malignancies. DESIGN, SETTING, AND PARTICIPANTS Case series identified from 125 426 samples submitted between February 15, 2012, and September 30, 2014, from asymptomatic pregnant women who underwent plasma cell-free DNA sequencing for clinical prenatal aneuploidy screening. Analyses were conducted in a clinical laboratory that performs DNA sequencing. Among the clinical samples, abnormal results were detected in 3757 (3%); these were reported to the ordering physician with recommendations for further evaluation.EXPOSURES NIPT for fetal aneuploidy screening (chromosomes 13, 18, 21, X, and Y). MAIN OUTCOMES AND MEASURESDetailed genome-wide bioinformatics analysis was performed on available sequencing data from 8 of 10 women with known cancers. Genome-wide copy-number changes in the original NIPT samples and in subsequent serial samples from individual patients when available are reported. Copy-number changes detected in NIPT sequencing data in the known cancer cases were compared with the types of aneuploidies detected in the overall cohort.RESULTS From a cohort of 125 426 NIPT results, 3757 (3%) were positive for 1 or more aneuploidies involving chromosomes 13, 18, 21, X, or Y. From this set of 3757 samples, 10 cases of maternal cancer were identified. Detailed clinical and sequencing data were obtained in 8. Maternal cancers most frequently occurred with the rare NIPT finding of more than 1 aneuploidy detected (7 known cancers among 39 cases of multiple aneuploidies by NIPT, 18% [95% CI, 7.5%-33.5%]). All 8 cases that underwent further bioinformatics analysis showed unique patterns of nonspecific copy-number gains and losses across multiple chromosomes. In 1 case, blood was sampled after completion of treatment for colorectal cancer and the abnormal pattern was no longer evident. CONCLUSIONS AND RELEVANCEIn this preliminary study, a small number of cases of occult malignancy were subsequently diagnosed among pregnant women whose noninvasive prenatal testing results showed discordance with the fetal karyotype. The clinical importance of these findings will require further research.

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Coexistence of Pregnancy and Malignancy

Cited by 316 publications

References 38 publications

Mortalidade materna tardia: comparação de dois comitês de mortalidade materna no Brasil

Mortalidade materna tardia: comparação de dois comitês de mortalidade materna no Brasil

Diagnosis and treatment of cervical cancer during pregnancy

Noninvasive Prenatal Testing and Incidental Detection of Occult Maternal Malignancies

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