Issue: Vol.83 (No. 8)

Maternal and fetal outcomes in pregnant women with lung cancer: a case report

Authors:
Suzana Drobnjak, Nataša Karadžov Orlić, Aleksandra Vasić, Jelica Uljarević, Svetlana Janković

Download full article PDF

Introduction. Lung cancer (LC) during pregnancy is rare, rarer than other types of malignancy. We present the case of a pregnant patient with advanced-stage LC, highlighting the diagnostic approach, pregnancy management, delivery, and postpartum course. Case report. A 46-year-old primiparous patient, 30 weeks pregnant with in vitro fertilization, was admitted to the hospital with right-sided chest pain and cough. The patient was a former smoker with a 15-year history of smoking. Due to the patient’s general condition and reported symptoms, an X-ray and computed tomography of the chest were performed. A massive necrotic lobulated tumor was revealed in the right lobe of the lung, involving the pleura and almost the entire lung parenchyma. A tru-cut biopsy of the lesion in the right lung was immediately performed. Histo-pathological examination of the biopsy specimen revealed a poorly differentiated neuroendocrine tumor of the small cell LC. At 32 weeks of gestation, signs of fetal hypoxemia were diagnosed, and the pregnancy was terminated by elective cesarean section. A male fetus weighing 1,550 g was born, with an Apgar score of 7/8, and after stabilization was referred to the Institute for Neonatology, Belgrade, Serbia. The placenta was sent for histopathological examination, and metastatic poorly differentiated neuroendocrine carcinoma was confirmed. The patient was presented to the Gynecological, Pulmonology, and Oncologic Councils, and radiotherapy was initiated immediately after delivery, but unfortunately, she died 7 days after delivery. Conclusion. The diagnosis and treatment of LC in pregnancy is challenging. That includes timely detection, treatment decisions and efficacy, as well as the potential risks for the fetus.