妊娠期结肠癌伴卵巢及腹腔转移一例  

A Case of Colon Cancer in Pregnancy with Ovarian and Abdominal Metastasis

作　　者：朱媛媛 许叶涛 孙丽洲[1] ZHU Yuan-yuan;XU Ye-tao;SUN Lizhou(The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院,210029

出　　处：《国际妇产科学杂志》2023年第4期437-441,共5页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金青年基金(82001578);江苏省自然科学基金(BK20201078)。

摘　　要：妊娠期结直肠癌发病率低,在临床上较为罕见,对于妊娠期结直肠癌的诊断方式、终止妊娠时机和治疗方案的选择尚未达成共识。报告1例妊娠期结肠癌合并卵巢及腹腔转移患者,妊娠中期因腹胀就诊,B超检查见大量腹水,结合磁共振成像检查、肿瘤标志物检查结果,行多学科会诊考虑恶性肿瘤可能性大,建议腹腔穿刺送检腹水明确诊断,根据病理结果,诊断为妊娠合并恶性肿瘤(消化道低分化腺癌),征求患者及其家属意愿后行利凡诺羊膜腔注药中期引产术,产后肠镜检查显示乙状结肠低分化腺癌,并于产后1个月行针对原发病的化疗。复习相关文献,以期为妊娠期结直肠癌的诊断和治疗提供经验。The incidence of colorectal cancer in pregnancy is low and rare in clinical practice.There is no consensus on the diagnosis method,timing of pregnancy termination and treatment options for colorectal cancer in pregnancy.This article reports a case of colon cancer in pregnancy with ovarian and abdominal metastases,who presented to the clinic with abdominal distension in mid-pregnancy,and a large amount of ascites were seen in ultrasound examination.Combining MRI,tumor index and multi-disciplinary team suggestions,it was considered that possibility of malignancy was high and recommended that abdominal puncture be performed to examine ascites for a clear diagnosis.Based on the pathological findings of ascites,a diagnosis of pregnancy with malignant tumors(poorly differentiated adenocarcinoma of the digestive tract)was made.After seeking the consent of the patient and her family members,she was induced with Levanon amniotic cavity injection midterm.Postpartum enteroscopy revealed poorly differentiated adenocarcinoma of the sigmoid colon and chemotherapy for the primary disease was administered one month after delivery.Meanwhile,the relevant literature was reviewed to provide experience for the diagnosis and treatment of colorectal cancer in pregnancy.

关 键 词：妊娠中期 结肠肿瘤 肿瘤转移 终止妊娠 多学科会诊 

分 类 号：R714.2[医药卫生—妇产科学] R735.35[医药卫生—临床医学]