title: Gastric carcinoma during pregnancy: report of a case.
abstract: OBJECTIVE
  Gastric cancer in pregnancy is extremely rare and often diagnosed at advanced stages. Well-recognized pregnancy-related symptoms, such as nausea and epigastric discomfort, can be the first symptoms of gastric cancer. Thus, the diagnosis of gastric cancer in pregnancy is difficult. We herein report a case of gastric cancer in pregnancy to alert clinicians to this rare possibility.
  
  
  METHODS
  A 22-year- old nulliparous woman was examined by a gynecologist with a complaint of low abdominal pain. An abdominal ultrasound of the patient revealed 7th week of gestation and also showed massive ascites. She was referred to a hospital for further evaluation. Her other symptoms included loss of appetite, early satiety, and postprandial fullness. Gastroscopy demonstrated a tumor originating from the cardia and invading throughout the distal corpus. The histopathological diagnosis was gastric carcinoma with signet ring cells and her pregnancy was terminated. An explorative laparotomy revealed an unresectable gastric cancer and multiple peritoneal implants. Tumoral invasion was detected in pancreas and spleen. She was admitted to the medical oncology clinic and received a palliative chemotherapy. Bilateral double-J-stent placement was performed because of obstructive uropathy. A nasogastric tube was inserted for intestinal decompression, and total parenteral nutrition was administered. An adequate pain medication was given. To date (3 months after the diagnosis) the patient has been well without any signs of progression.
  
  
  CONCLUSIONS
  Early diagnosis of gastric cancer is very important for a better outcome. The diagnosis may be delayed because mild gastrointestinal symptoms are common during pregnancy. Clinicians should take this into consideration in the differential diagnosis of persistent epigastric complaint during pregnancy. Suspicion and early upper gastrointestinal endoscopy are necessary.
authors: Department of Internal Medicine, Division of Medical Oncology, Dokuz Eylül University, School of Medicine, Izmir. tugba.gun@deu.edu.tr
authors: Ilkay Tuğba
authors: IT
authors: Unek
authors: Aygül
authors: A
authors: Celtik
authors: Ahmet
authors: A
authors: Alacacioğlu
authors: Suna
authors: S
authors: Cokmert
authors: Tuğba
authors: T
authors: Yavuzşen
authors: Nedim Serkan
authors: NS
authors: Doğan
authors: Ilhan
authors: I
authors: Oztop
authors: Binnaz
authors: B
authors: Demirkan
authors: Uğur
authors: U
authors: Yilmaz
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000032:Abortion, Therapeutic; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001201:Ascites; D002277:Carcinoma / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000188:drug therapy; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents