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Carcinoma Following Pregnancy With Spontaneous Cure

Levine & Weiner, 1945Other/Unknown

American Journal of Obstetrics and Gynecology 49: 1945; 778-782

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Abstract

Diffuse carcinoma of the peritoneum and mesentery is generally metastatic. It is usually inoperable because of its extensive spread and involvement of adjacent organs. A case is reported in which multiple metastases in the abdominal cavity were found 4 months postpartum. Three years postoperative the patient was pregnant again. In view of her history, the surgical, medical, and pathological departments advised termination of the pregnancy by abdominal hysterotomy and sterilization. Upon operation no evidence of carcinomatous tissue was found.

Case Details

Personal Characteristics

34-year-old primipara, had a normal pregnancy, had an appendectomy in 1932

Clinical Characteristics

Colicky pains in the upper abdomen, weakness, fatigue, epigastric fullness, nausea and vomiting, anorexia, frequency of urination, loss of weight, small, tender pedunculated fibroid attached posteriorly to the uterus, large, tender, fixed mass in the mid abdomen, enlarged and tender liver, free hemorrhagic fluid in the peritoneal cavity, multiple metastatic nodules in liver, multiple implants on the peritoneum and in the omentum, large, firm mass involving the gastrocolic omentum and the transverse colon, two pedunculated fibroids in uterus, ovaries studded with peritoneal implants

Remission Characteristics

Masses not felt, liver enlargement receded, gained weight, regular menses, no complaints, no evidence of carcinomatous degeneration upon second operation

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Laparotomy, biopsy, total hysterectomy with bilateral salpingo-oophorectomy

Additional Notes

Patient was pregnant again three years postoperative. The surgical, medical, and pathological departments advised termination of the pregnancy by abdominal hysterotomy and sterilization. Upon operation no evidence of carcinomatous tissue was found.