[Mediastinal large B-cell lymphoma with symptomatic superior vena cava syndrome in a patient with bichorial twin pregnancy in the 26th week of gestation: peri-and postpartal management -- a case report].
OBJECTIVE
Non-Hodgkin lymphoma (NHL) is rarely observed during pregnancy. The clinical behavior of this malignancy does not differ significantly from that outside of the setting of pregnancy. Antineoplastic chemotherapy is usually given during the second and third trimester. However, irradiation is another therapeutic option. The teratogenic potential limits its use in pregnancy. Finding an appropriate therapeutic management in an emergency setting is therefore difficult.


METHODS
In this report, we describe the case of a 31-year-old gravida three, para two, in whom a mediastinal large B-cell lymphoma with symptomatic superior vena cava syndrome was diagnosed in a bichorial twin pregnancy in the 26 (th) week of gestation. After premature delivery by caesarean section at 26 + 0 weeks gestation the patient was immediately submitted to mediastinal irradiation. The clinical symptoms resolved and adjuvant CHOEP-chemotherapy was instituted. Chemotherapy was well tolerated and a partial remission was observed after 4 cycles. The neonatological follow-up was uneventful.


CONCLUSIONS
To our knowledge, this is the first case in the literature of a patient with bichorial twin pregnancy with large cell mediastinal NHL and symptomatic superior vena cava syndrome who underwent irradiation after caesarean section because of life-threatening medical condition.
Djakovic
A
A
Frauenklinik der Universität Würzburg. adjakovic@gmx.de
Ott
G
G
Zollner
U
U
Vordermark
D
D
Dietl
J
J
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002585:Cesarean Section; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016393:Lymphoma, B-Cell / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D010298:Parity; D011239:Prednisolone / Q000008:administration & dosage; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000188:drug therapy; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis*; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone