Merkel cell tumor in pregnancy. A case report

A Merkel cell tumor occurred in a young, pregnant woman. The patient delivered prematurely, and the infant died of prematurity. The patient died within two years of the diagnosis.     

Phyllodes tumor and pregnancy. A report of a case

Phyllodes tumor is a rare breast fibroepithelial neoplasm of the breast, predominant in females (0.3 to 0.5%). Few cases have been described in males. Phyllodes tumor during pregnancy grows fast and its size is relatively big. These tumors can be classified as benign, malignant or neighboring. A 32-year-old patient at 23.4 week of gestation was admitted in the National Institute of Perinatology with a rapidly growing mass in the right breast; diagnosis confirmed by ultrasound study reporting echoic images on right breast, 10 x 10 cm the greatest and 3x3 cm the smallest. A simple mastectomy was performed at the 26.6 week of gestation on the right breast. A possible phyllodes tumour in the right breast was observed during surgery, weight 9.6 pounds, with partial infiltration to major pectoral muscle. Pathology reported a benign phyllodes tumor in the right breast, with surgical borders free of tumor. Phyllodes tumor is rare and can occur during pregnancy. It is unknown if the tumor is hormone-dependent. The growth of a tumor on a subsequent pregnancy is not necessarily associated with recurrency or with a new disorder on the patient, who has had a complete excision.     

Adenocarcinoid tumor of the ovary diagnosed during pregnancy. A case report

BACKGROUND: Adenocarcinoid tumors are uncommon neoplasms with dual morphology, showing components of a neuroendocrine tumor with carcinoid features and an adenocarcinomatous component composed of glands lined with mucin-containing cells, some of which are goblet type. CASE: A 36-year-old woman had a left adnexal mass found during the second week of pregnancy. Sonography showed it to be increasing in size and eventually to become associated with pelvic pain. During the 20th week of gestation, an exploratory laparotomy was performed, and the left ovary and fallopian tube were excised. A diagnosis of adenocarcinoma was rendered by intraoperative frozen section. A staging procedure was then performed that included removal of the contralateral adenexa, pelvic lymph node sampling, peritoneal biopsies and partial omentectomy. The vermiform appendix and gastrointestinal tract appeared unremarkable. The patient was discharged. Permanent sections of the left ovary revealed an adenocarcinoid tumor. CONCLUSION: While reports detail ovarian metastases of adenocarcinoid neoplasms from primary appendiceal and other gastrointestinal sites, this case, in the setting of a normal appendix and negative workup for an extraovarian origin, is the fourth documented one of a primary ovarian adenocarcinoid tumor and first diagnosed during pregnancy.     

Dermatomyositis in pregnancy. A case report

Few cases of dermatomyositis affecting pregnancy have been reported. In this case the fetal outcome was good, but postpartum, pregnancy-induced hypertension was associated with acute exacerbation of the disease and led to maternal death. Both the fetal and maternal outcome differed from those in previously reported cases.     

Interstitial pregnancy. A case report

Interstitial pregnancy is uncommon, and the correct diagnosis requires awareness of this form of ectopic pregnancy.     

Intraligamentous pregnancy. A case report

A patient experienced fetal demise at 33 weeks' gestation. Numerous attempts at induction of labor failed. It was not until a laparotomy was performed that the intraligamentous location of the pregnancy was determined. Although this diagnosis is rarely made preoperatively, repeated failure of induction should raise the suspicion of an abnormal implantation site.     

Extra-amniotic pregnancy. A case report.

A case of extra-amniotic pregnancy ending in premature labour at 35 weeks is reported.     

Cervical pregnancy. A case report.

A cervical pregnancy was treated successfully with systemic methotrexate and folic acid. Serial beta-human chorionic gonadotropin levels, color Doppler velocimetry and hysteroscopy were used to monitor therapy. In view of the substantial morbidity associated with this form of ectopic pregnancy, medical management is an option for treatment.     

Nutmeg intoxication in pregnancy. A case report

A case of acute anticholinergic hyperstimulation in a pregnant woman was associated with excessive ingestion of nutmeg. The typical symptoms and signs, differential diagnosis and therapy are reviewed, with a special emphasis on the pregnant state.     

Systemic nocardiosis in pregnancy. A case report

Pregnancy in women with significant medical complications has become a part of modern obstetrics. We report a case of systemic nocardiosis in a gravida with sarcoidosis. The importance of aggressive management and the influence of pregnancy on antibiotic treatment are discussed.     

Midgut volvulus in pregnancy. A case report

Midgut volvulus in pregnancy is rare. Preoperative diagnosis is difficult and may be complicated by pregnancy, labor and the post-cesarean-section state. In a case of total midgut volvulus after cesarean section, a massive resection of the small bowel was performed.     

Cerebellar hemangioblastoma in pregnancy. A case report

BACKGROUND: The incidence of symptomatic hemangioblastoma of the posterior fossa during pregnancy is extremely low. Previous reports have noted that pregnancy seems to aggravate the clinical course of intracranial tumors, but little is known about the possible reasons. Various theories have been proposed to explain the rapid neurologic deterioration of hemangioblastoma patients during pregnancy; however, the pathophysiologic behavior and histogenesis of this vascular tumor are still not well understood. CASE: A case of cerebellar hemangioblastoma was diagnosed during pregnancy. Urgent surgery was required due to rapid development of obstructive hydrocephalus and brainstem compression. CONCLUSION: Obstetricians and neurosurgeons should be aware of the rare clinic entity of hemangioblastoma during pregnancy. Surgery might be indicated as soon as the tumor becomes symptomatic.     

Status epilepticus in pregnancy. A case report

A 34-year-old woman, epileptic since childhood, was admitted during the 26th-27th week of her second pregnancy because of status epilepticus. Effective treatment of the seizures allowed the pregnancy to reach term, and a healthy infant was born. A conservative treatment regimen involving seizure control and preservation of pregnancy is recommended.     

Roseola infantum in pregnancy. A case report.

Roseola infantum (exanthem subitum) was first described as a specific syndrome by Zahorsky in 1913. It is a benign disease that occurs almost exclusively in infants and young children (six months to three years of age). We report a case of roseola in a pregnant woman. We were unable to find any prior reports of roseola in pregnancy. The classic presentation of roseola is characterized by high temperatures (103-105 degrees F) that last 3-5 days and resolve by crisis followed by the appearance of a morbilliform rash that lasts a few hours to a few days. The infectious agent is human herpesvirus-6. We recommend the addition of roseola to the differential diagnosis of rashes that occur in pregnancy. The potential danger to the fetus from this virus is unknown.     

Insecticide poisoning in pregnancy. A case report.

A 25-year-old multigravida drank an organochlorine insecticide in an attempt to commit suicide at 16 weeks of pregnancy. This resulted in the death of twin fetuses and vaginal bleeding. The pregnancy was terminated using gemeprost, syntocinon and later surgical evacuation of the uterus. She developed respiratory arrest after the fetuses were aborted and also after surgical evacuation. On both occasions, she was intubated and mechanically ventilated. We believe that organochlorine insecticides may be fetocidal. In addition, surges in blood levels may occur during termination of pregnancy, delivery or evacuation of retained products of conception.     

Status epilepticus in pregnancy. A case report

Status epilepticus is a serious emergency that rarely complicates the management of the pregnant patient with seizure disorders. Because of concerns regarding the safety of anticonvulsion medications, this condition may appear with increasing frequency. Our management of such a case resulted in a healthy mother and infant.     

Colon cancer in pregnancy. A case report.

BACKGROUND: Carcinoma of the colon diagnosed during pregnancy is very rare. Delayed diagnosis is common because of the similarity between early signs and symptoms of colon cancer and gastrointestinal complaints often experienced by pregnant women. We report a case of early-stage colon cancer in pregnancy with a good outcome. CASE: A 35-year-old woman presented with rectal bleeding at 26 weeks of gestation. Initial assessment with digital examination and proctoscopy revealed only a mild degree of hemorrhoids. Colonoscopy and biopsy at 30 weeks of gestation showed sigmoid colon cancer. Cesarean section was performed after steroid therapy. Subtotal colectomy and ileosigmoid anastomosis were then performed at the same setting. Postoperative adjuvant chemotherapy was given. There was no evidence of recurrence at this writing, 28 months after surgery. CONCLUSION: Colon cancer is a rare complication of pregnancy. The associated poor prognosis is usually due to delay in diagnosis. A high index of suspicion is essential, and it is important not to underestimate the patient's symptoms. Early diagnosis is the key to longer survival.     

Typhoid fever in pregnancy. A case report

A pregnant woman was treated for typhoid fever. A consideration of geographic risks and serologic clues helped determine the diagnosis.     

May-Hegglin anomaly in pregnancy. A case report

The May-Hegglin anomaly is a rare autosomal dominant platelet disorder that can be associated with significant bleeding. We treated a patient for pregnancy complicated by the May-Hegglin anomaly and a complete placenta previa.