Editorial
The Treatment of Rectal Cancer in Pregnant Patient
Alaattin Öztürk*
Department of General Surgery, Adatip Hospital, Turkey
*Corresponding author: Alaattin Öztürk, Department of General Surgery, Adatip Hospital, Turkey
Published: 08 Dec, 2017
Cite this article as: Öztürk A. The Treatment of Rectal
Cancer in Pregnant Patient. Clin Surg.
2017; 2: 1812.
Editorial
Purpose
We want to report this case that the process of diagnosis and treatment for the rectal cancer is
conduct without harming the pregnancy.
Case
A woman, 36 years old, was applied to the hospital with bloody stool complaint. A mass has
been palpated at the tip of finger on the rectal examination. The patient was 6th weeks gestation.
A vegetative mass has revealed on colonoscopy, starting from 9th cm and occluding the lumen. A
3 cm × 4 cm mass was detected 9 cm proximal from anal verge, obstructing almost completely the
lumen in rectal ultrasound and magnetic resonance imaging. There was not a pathologic lymph
node and any findings for metastases to other organs in the pelvic region. The patient has been
examined by gynecologist. Surgery was recommended to the patient for rectal cancer after medical
abortion. The risks of the operation and the effect of chemotherapy on the fetus were explained
to the patient who accepted the surgery but did not accept the medical abortion. A low anterior
resection and preventive ileostomy were performed for the patient who accepted these risks. She
was discharged postoperative 6th day without any complications. The fetus was determined alive and
healthy on gynecologic examination before and after surgery. Histopathology revealed mucinous
rectal adenocarcinoma. Chemotherapy was recommended to the patient by the oncologist after the
operation. But the patient did not accept chemotherapy due to side effects of drugs. The patient
applied 3 months after the operation and multiple metastatic masses were detected in the liver on
ultrasound. The patient was reevaluated by the oncologist. Chemotherapy was started to the patient
whom her pregnancy reached the sixth month. The patient gave birth to a live baby with cesarean
section at the 36th week of gestation and the protective ileostomy was closed during cesarean section.
After delivery, abdominal and thorax computed tomography revealed multiple metastatic lesions in
the liver. The patient was also given radiotherapy in addition to chemotherapy. Two years after the
operation, pulmonary metastases were detected in patient who reapplied with dyspnea and cough.
Despite of symptomatically treatment patient died due to liver and lung failure.
Discussion and Conclusion
It is necessary to avoid any practices that harmful the fetus during the diagnosis and treatment of pregnant patients. Surgery may be difficult because enlarged uterus restricted space for it. If the patient does not want an abortion, rectal cancer can be treated when the pregnancy is ongoing. But surgical and oncologic treatment may not be performed as required.