A Case of Hereditary Nonpolyposis Colorectal Cancer with Multiple Liver Metastases During Pregnancy

Masakazu Ikenaga, Mitsugu Sekimoto, Hirofumi Yamamoto, Masataka Ikeda, Yasuhiro Miyake, Heiro Kim, Shingo Noura, Hiroaki Nagano, Masato Sakon and Morito Monden

Department of Surgery and Clinical Oncology, Graduate school of Medicine, Osaka University

A 40-year-old woman 22 weeks and 5 days pregnant suffered right upper abdominal pain. Her history showed that her father had rectal cancer and died of liver failure, and her sister had colon cancer. This family matched the criteria of Hereditary Non-Polyposis Colorectal Cancer (Amsterdam criteria II). Ultrasonography (US) of the abdomen showed liver tumors finally diagnosed as sigmoid colon cancer with multiple liver metastases at 23 weeks and 2 days of pregnancy. After discussion with the patient and her family, we decided to wait until 28 weeks into the pregnancy to ensure a safe delivery, then therapy for cancer would be done. Due to the patient's worsening condition, however, we had to conduct emergency surgery 24 weeks and 4 days into the pregnancy, resulting in fatal death 4 hours postoperatively and the patient's death of multiple organ failure 13 days postoperatively. The treatment of cancer during pregnancy thus requires best selection of therapy based on the many factors attending the particular pregnancy.

Key words
colorectal cancer, pregnancy, hereditary nonpolyposis colorectal cancer

Reprint requests
Masakazu Ikenaga Department of Surgery, National Hospital Organization Osaka National Hospital
2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006 JAPAN

Accepted
January 26, 2005

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