Metastatic colon adenocarcinoma in pregnancy / Philippine Journal of Obstetrics and Gynecology

@#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.

Recurrent dedifferentiated retroperitoneal liposarcoma complicating pregnancy / Philippine Journal of Obstetrics and Gynecology

@#Retroperitoneal liposarcoma is an uncommon tumor both in the pregnant and nonpregnant state. Its exact incidence is unknown because of its rarity. Due to its propensity for local recurrence, prognosis depends on histologic subtype and negative margins of resection. Surgery remains the mainstay of treatment, and timing is critical in terms of finding a surgically resectable lesion while balancing fetal risks. This report describes tumor recurrence in a pregnancy with a prior history of surgery for an atypical lipomatous tumor presenting as a retroperitoneal mass. After discussion with the multidisciplinary team, as well as with the patient’s consent, the plan was to defer surgery until 34 weeks, followed by scheduled tumor removal 2 weeks postpartum. She delivered abdominally to a baby girl with a good outcome. Histopathology showed dedifferentiated liposarcoma with a positive tumor margin. The patient has survived at 6-month follow-up and completed four cycles of chemotherapy with doxorubicin, ifosfamide, and mesna. However, surveillance imaging again showed tumor recurrence.