Lung Cancer In Pregnancy Research Articles

Primary Lung Adenocarcinoma in Pregnancy: A Case Report

Case Report: This is a unique case of metastatic primary lung adenocarcinoma diagnosed in a 25-year-old G3P2002 at 15 weeks of gestation. The patient presented with acute onset of left chest and shoulder pain. Evaluation revealed anaplastic lymphoma kinase (ALK) positive, primary lung adenocarcinoma with metastasis to the liver and right adrenal gland. Treatment with palliative Alectinib 450 mg twice daily was initiated at 18 weeks gestation and increased to Alectinib 600 mg twice daily at 27 weeks gestation. Uncomplicated delivery occurred via spontaneous vaginal delivery following scheduled induction at 39 weeks and 2 days. There are few cases of lung cancer in pregnancy, and none which describe delivery at term in a patient with metastatic disease. This case provides insight on the treatment of ALK positive metastatic lung cancer during the second and third trimesters of pregnancy without necessitating preterm delivery or cesarean section.

Metastatic lung cancer in pregnancy - a diagnostic and management challenge: A case report

Background: Lung cancer during pregnancy remains an uncommon occurrence. As of 2016, there were less than 70 histologically confirmed lung cancer in pregnancy cases reported in the literature. Case presentation: A 29-year-old woman presented with a chronic cough in the second trimester of pregnancy at the Kenyatta National Hospital (KNH) as a referral. Treatment for Pulmonary Tuberculosis (PTB) was initiated in a peripheral facility based on suggestive signs on the chest radiograph. Symptoms persisted while on anti-TB medication. On further evaluation, she was diagnosed with advanced squamous cell lung cancer. The patient went into spontaneous labor and vaginally delivered a fresh stillbirth. She received palliative care, and succumbed from disease progression. Conclusion: Lung cancer during pregnancy exhibits similar clinical presentation to prevalent conditions, especially in low-resource and TB prevalent settings, and pose challenges in early diagnosis, and consequently, poor outcome. Chronic cough should raise suspicion for malignancy and prompt investigation.

SQUAMOUS CELL CARCINOMA OF THE LUNG METASTATIC TO THE PLACENTA

SESSION TITLE: Medical Student/Resident Lung Cancer Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Carcinoma of the lung is an uncommon condition during pregnancy. We present here a case of a young 32-year-old female G4P3003 with a 2 pack-year history of smoking who presented to the hospital for a spontaneous vaginal delivery and was found to have a new squamous cell carcinoma of the lung metastatic to the placenta. CASE PRESENTATION: 32 year-old-female G4P3003 with a 2 pack-year history of smoking presented to the hospital at 39w2d for the management of labor. The pregnancy course was complicated by unintentional weight loss of 10 pounds in the last 3 months. She was admitted to the labor and delivery unit and underwent spontaneous vaginal delivery of a healthy baby boy and the placenta was sent to the pathology department for evaluation. 24 hours after the delivery the patient developed dyspnea and required 2L of oxygen to maintain SpO2 >92%. She has had no night sweats, fevers, chills, nor any productive cough including hemoptysis. On auscultation, there was diffuse wheezing throughout the lung fields bilaterally. The patient was placed on a bronchodilator protocol and CTA of the chest was obtained which ruled out a PE but showed a right-sided lung mass with extensive bulky adenopathy involving the right perihilar, paratracheal, subcarinal and pre-carinal regions. She had an EBUS bronchoscopy with TB-FNA of mediastinal mass and right paratracheal and subcarinal lymph nodes. The biopsy showed squamous cell carcinoma of the lung. The tumor cells expressed p40 and cytokeratin 5/6, but negative for p16, TTF-1 and Placental alkaline phosphatase (PLAP). 100% of tumor cells are positive for PD-L1 (membranous positivity). Placenta was analyzed which showed multifocal involvement by squamous cell carcinoma with villous infarcts. Immunohistochemistry markers were similar to the lung biopsy specimen. Additional imaging also showed liver and breast involvement. Thus, the patient was diagnosed with stage IVB (T1c N3 M1c) metastatic SCC and was placed on single-agent pembrolizumab 200 mg IV every 3 weeks. DISCUSSION: Lung cancer metastasizing to the placenta is uncommon. Most of the lung cancers reported in these cases were non-small cell lung cancers. The prognosis in these reported cases was poor and the cancers were inoperable. Very few cases reported harmful consequences for the neonate and there was no direct evidence of adverse effects of pregnancy on the prognosis of lung cancer in pregnant women, but these cases were diagnosed in stages III-IV. Thus, it needs further research on why gestational metastatic cancers follow an aggressive course. Thus, it is important to report similar cases for further research. CONCLUSIONS: Gestational lung cancers diagnosed in advanced stages have aggressive behavior, chemotherapy offers poor results and overall survival is short. Reference #1: Jackisch, C., Louwen, F., Schwenkhagen, A. et al. Arch Gynecol Obstet (2003) 268: 69. https://doi.org/10.1007/s00404-002-0356-x Reference #2: Pentheroudakis G., Pavlidis N. Cancer and pregnancy: poena magna, not anymore. Eur J Cancer. 2006;42(2):126–140. Reference #3: Boussios S., Han S.N., Fuscio R., Halaska M.J., Ottevanger P.B., Peccatori F.A. Lung cancer in pregnancy: report of nine cases from an international collaborative study. Lung Cancer. 2013;82:499–505. DISCLOSURES: No relevant relationships by James Choi, source=Web Response No relevant relationships by Aaron Nichols, source=Web Response No relevant relationships by Fazal Raziq, source=Web Response

An Indonesian Pregnant Woman with Lung Cancer and Liver Metastasis : A Case Report

Background: Lung cancer in pregnancy is a rare disease compared to other types of cancer. However, special issue should be applied in order to maximize benefit for mother without harming the fetus.Methods: We present a case of 37-year-old, five months pregnant woman who came to the hospital with chief complain of shortness of breath. Later on, she was found to have a stage IV Non-Small Cell Lung Cancer (NSCLC) with adenocarcinoma subtype.Result: This may be the first lung cancer in pregnancy reported in Indonesia. Being a developing country, several challenges emerged before diagnosing patient of having lung cancer.Conclusion: Careful considerations along with multidisciplinary approach are necessary to provide the best care for the patient.

Lung cancer in pregnancy: Report of nine cases from an international collaborative study

ObjectiveLung cancer is an uncommon diagnosis during pregnancy. The combination of smoking in young women, increased maternal age during pregnancy, and increasing incidence of lung cancer worldwide may cause an increase of pregnancy associated lung cancer. The aim of this study was to describe all cases of lung cancer during pregnancy, registered in the international Cancer in Pregnancy registration study (CIP study; www.cancerinpregnancy.org). Materials and methodsWe present nine cases, all advanced lung cancer during the course of pregnancy. Collected data included demographic features of the study patients, cancer treatment, pregnancy outcome as well as maternal and fetal outcomes. Results and conclusionNine pregnant patients from 4 European centres with a median age of 33 years old (range, 26–42) were included. The median gestational age at diagnosis was 17 weeks (range, 6–28). All patients presented with metastatic disease including bone, lung, brain, spinal cord, pleura, lymph nodes, adrenal and liver. Histopathology was compatible with adenocarcinoma in 4 patients, non-small cell lung cancer with unidentified subtype in 2 patients and squamous-cell, large-cell and a poorly differentiated carcinoma in 3 patients, respectively. Eight patients were treated with systemic therapy, five of them during gestation. No responses were seen. The maternal postpartum outcome was poor with less than one year survival following delivery. One patient experienced a spontaneous abortion and three pregnancies were terminated. Five infants were all born premature due to poor maternal status by cesarean section, with a median gestational age of 30 weeks (range 26–33).To summarize, lung cancer in pregnancy has a dismal maternal outcome in our series. We add nine new cases and discuss both therapeutic and prognostic results.

METASTATIC PULMONARY ADENOCARCINOMA TO PLACENTA AND PLEURAL FLUID: Clinicopathologic Findings

Objectives: To report the clinicopathologic findings of a pregnant woman with Stage IV adenocarcinoma of the lung with placental metastasis. Materials and methods: Medical records review. Results: A 31-year-old G2P1001 woman was diagnosed with Stage IV metastatic adenocarcinoma of the lung. At 34 weeks’ and 2 days’ gestation, she went into preterm labor and delivered a live male infant, weighing 2595 grams, with Apgar scores of 9 and 9, respectively. Placental pathology was significant for adenocarcinoma with a solid and acinar pattern, consistent with that from the lung. Her postpartum course was uneventful. She did not receive chemotherapy and expired one month postpartum. To date, the infant is without evidence of disease. Conclusions: The occurance of lung cancer in pregnancy is rare and a few cases have been reported in literature. Placental metastasis is extremely uncommon in these cases and can lead to fetal involvement by lung tumor. It is important to report all cases of lung cancer occurring in pregnancy with subsequent close clinical surveillance of the infant as all cases have a different clinical picture.

Anaesthesia for caesarean section in a woman with lung cancer: case report and review

A 33-year-old woman pregnant with twins was diagnosed with metastatic lung cancer during pregnancy. Her multidisciplinary care raised many medical and ethical issues. To help decide on the best anaesthetic technique for caesarean section, a literature search of published case reports of pregnancy associated with lung cancer was performed. Thirty-five cases of primary lung cancer associated with pregnancy were found. Anaesthetic technique was reported in only five of the 20 patients who underwent caesarean section: one spinal, three epidurals and one general anaesthetic. Of the 11 patients who delivered vaginally, only one was reported to have received epidural analgesia. As published data regarding anaesthesia and analgesia are limited for women with lung cancer in pregnancy, we describe our perioperative approach and review the potential challenging aspects of management in a pregnant patient with metastatic lung cancer.

Advanced lung cancer presenting with a generalized seizure in pregnancy

This case describes the initial presentation of lung cancer as a generalized seizure in a woman at 31 weeks gestation. Histologic examination revealed evidence of placental metastases without evide...

Lung cancer in pregnancy: case reports and review of the literature

Lung cancer diagnosed in pregnancy is rare. The number of reported cases has been escalating in recent years, probably reflecting the increasing number of women of reproductive age who smoke. This review presents three cases of lung cancer in pregnancy with different manifestations and outcomes, with a review of the literature. Physicians should have a low threshold using different diagnostic tools for investigating unusual symptoms during pregnancy without fear for fetal safety. Once diagnosed, lung cancer represents a major ethical and medical dilemma. The optimal management of lung cancer in pregnancy is not known, because of the rarity of the cases reported during pregnancy and insufficient follow-up data.