title: Neuroendocrine carcinoma of the vagina in pregnancy.
abstract: BACKGROUND
  Neuroendocrine carcinoma of the vagina is extremely rare. Treatment options in pregnancy are complex owing to the aggressive tumor type and poor prognosis.
  
  
  METHODS
  We report the case of a gravid woman diagnosed with stage IVB neuroendocrine carcinoma of the vagina at 16 weeks of gestation. Disease responded to chemotherapy, and pregnancy was continued until onset of preterm labor at 28 5/7 weeks of gestation, with subsequent delivery of a viable fetus. Despite aggressive treatment with chemoradiation postpartum, the patient died of progressive disease 11 months after initial diagnosis.
  
  
  CONCLUSIONS
  A multidisciplinary team should review treatment options and potential complications with the patient. Because of the tendency toward early tumor dissemination, the optimal treatment for neuroendocrine carcinoma in pregnancy involves systemic chemotherapy.
authors.affiliation: From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, and the Division of Gynecologic Oncology, University of Tennessee-West Clinic, Memphis, Tennessee; and the Divisions of Maternal-Fetal Medicine, Duke University Medical Center, Durham, North Carolina, and Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Adam C
authors.initials: AC
authors.lastname: ElNaggar
authors.forename: Avinash S
authors.initials: AS
authors.lastname: Patil
authors.forename: Krishna
authors.initials: K
authors.lastname: Singh
authors.forename: Mark E
authors.initials: ME
authors.lastname: Reed
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D050498:Live Birth; D008113:Liver Neoplasms / Q000556:secondary*; D008207:Lymphatic Metastasis; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy / Q000473:pathology*; D014625:Vaginal Neoplasms / Q000188:drug therapy / Q000473:pathology*