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Zhou JP, Wang Y, Lin YN, Sun XW, Ding YJ, Yan YR, Li N, Zhang L, Li QY. Clinical Features and Management of Lung Cancer During Pregnancy: A Narrative Review Based on Reported Cases. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:544-550. [PMID: 38023372 PMCID: PMC10664570 DOI: 10.1089/whr.2023.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
This review aims to provide a summary of the clinical characteristics and outcomes of lung cancer during pregnancy. A comprehensive literature search yielded 93 cases of lung cancer during pregnancy from 1953 to 2022, with an average maternal age of ∼34 years old. The initial symptoms reported were often nonspecific, such as cough, dyspnea, and chest pain. Cancer-related treatments, including surgery, radiotherapy, chemotherapy, and tyrosine kinase inhibitors, have shown beneficial effects on maternal outcomes. A majority of the newborns were born without malformation or diseases, but extended follow-up remains necessary. Early diagnosis of lung cancer is imperative for reducing the risks of placental and fetal metastasis and enhancing overall survival.
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Affiliation(s)
- Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Wang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Jie Ding
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ya Ru Yan
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ma Q, Shu P, Zhou K, Wang Y. Case Report: Termination of unplanned pregnancy led to rapid deterioration of non-small-cell lung cancer during osimertinib treatment. Front Oncol 2023; 13:1073938. [PMID: 37916176 PMCID: PMC10616458 DOI: 10.3389/fonc.2023.1073938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 09/20/2023] [Indexed: 11/03/2023] Open
Abstract
We present a case of a woman with non-small-cell lung cancer (NSCLC) who experienced disease progression during treatment with the epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) osimertinib due to an unplanned pregnancy. Given the risk of tumor progression, the patient underwent an artificial abortion. However, disease deterioration occurred shortly after termination of the pregnancy, with severe chest pain, increased dyspnea, and pleural effusion. After positive rescue measures, including emergency thoracic drainage, thoracentesis, and oxygen uptake, her symptoms improved. Considering pregnancy as an immune escape physiological process, the patient continued treatment with osimertinib, and a partial response (PR) lasting 16 months was observed. Therefore, this case highlights the importance of being vigilant about the rapid development of the tumor after delivery in pregnant patients with EGFR-mutation lung cancer and taking preventive measures to cope with various emergencies.
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Affiliation(s)
- Qizhi Ma
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Pei Shu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Kexun Zhou
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yongsheng Wang
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Watanabe T, Yamashita T, Sugawara H, Fukuchi T, Ishii A, Nagai Y, Ohyanagi F, Koyama S, Ushijima J, Takagi K, Tanaka A. Rapid Progression of Lung Cancer Following Emergency Caesarean Section Led to Postpartum Acute Respiratory Failure. Intern Med 2019; 58:991-997. [PMID: 30449778 PMCID: PMC6478973 DOI: 10.2169/internalmedicine.1105-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Our case patient was a 38-year-old pregnant Japanese woman who underwent emergency Caesarean section because of massive vaginal bleeding due to a low-lying placenta. Immediately after delivery, she presented with rapidly progressive dyspnea. Contrast-enhanced computed tomography revealed bilateral pleural effusion, lung nodules, multiple liver tumors, and multiple osteolytic lesions. Accordingly, epidermal growth factor receptor-mutant advanced lung adenocarcinoma was diagnosed. This report highlights the occurrence of rapid progression of lung cancer following delivery that led to postpartum acute respiratory failure, rather than due to pulmonary thromboembolism associated with the existing deep venous thrombosis of the inferior vena cava.
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Affiliation(s)
- Tamami Watanabe
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan
| | - Takeshi Yamashita
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan
| | - Hitoshi Sugawara
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan
| | - Takahiko Fukuchi
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan
| | - Akira Ishii
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Japan
| | - Yoshiaki Nagai
- Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Japan
| | - Fumiyoshi Ohyanagi
- Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Japan
| | - Shinichiro Koyama
- Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Japan
| | - Junko Ushijima
- Perinatal and Maternal Center, Department of Comprehensive Medicine 2, Saitama Medical Center, Jichi Medical University, Japan
| | - Kenjiro Takagi
- Perinatal and Maternal Center, Department of Comprehensive Medicine 2, Saitama Medical Center, Jichi Medical University, Japan
| | - Akira Tanaka
- Department of Pathology, Saitama Medical Center, Jichi Medical University, Japan
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Thelmo MC, Shen EP, Shertukde S. Metastatic pulmonary adenocarcinoma to placenta and pleural fluid: clinicopathologic findings. Fetal Pediatr Pathol 2010; 29:45-56. [PMID: 20055563 DOI: 10.3109/15513810903266625] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
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 G(2)P(1001) 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.
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Affiliation(s)
- Marylou C Thelmo
- Department of Obstetrics and Gynecology, Kern Medical Center-UCLA, Bakersfield, California 93305, USA
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