GASTRIC CANCER IN PREGNANCY

Case report: In 28-year-old woman the mild gastrointestinal symptoms during second and third trimester were accompanied with severe anemia and starting pruritic erythematous eruption on the arms. Patient with mild disease required only frequent application of topic cordicosteroid. Sudden symptoms of premature labour started at 32-nd week of pregnancy. Infant died during the labor. Gastrofiberoscopy with a biopsy confirmed a diagnosis of diffuse gastric adenocarcinoma. An explorative laparotomy revealed an unresectable gastric cancer and multiple peritoneal implants. Tumoral invasion was detected in pancreas and spleen. Curative surgery was not possible. The definitive diagnosis was gastric adenocarcinoma with multiple metastases. The patient complained of dysphagia, retrosternal pain, nausea, vomiting and abdominal pain and she died 12 weeks after a surgery due to metastases. Discussion: Davis and Chen from Cedars-Sinai Medical Center reported a case of gastric carcinoma presenting as an exacerbation of ulcers during pregnancy. They stated: »Gastric cancer is unusual during pregnancy. Also, because of the physiologic changes that occur with pregnancy, it is rare to see a worsening of peptic ulcers during pregnancy«. Bruggmann et al reported recently a case of gastric carcinoma in pregnancy. They declare: »Fetal metastasis is a rare entity, therefore caesarean section and chemotherapy should not be performed until fetal maturity. If vomiting and nausea are prolonged after the sixteenth week of pregnancy a malignant disease of the stomach should be excluded.« Jasmi et a1.3 reported a 27 year old woman at 16 week's gestation who presented with a perforated malignant gastric ulcer and peritoneal carcinomatosis.