title: Lung cancer and pregnancy.
abstract: Lung cancer in the pregnant woman is a very rare and dramatic coincidence with poor prognosis. Treatment depends on the gestational week of the pregnancy, patient's medical status, social, personal, familial, and even religious beliefs. We present a case of adenocarcinoma of the lung in a 34-year-old pregnant patient whose initial complaints were cough, dyspnea, fever and fatigue. She was diagnosed with pneumonia at another hospital, and antibiotic therapy was administered. Meanwhile, at 28 weeks she delivered a preterm low-birth-weight baby. Chest X-ray and thorax CT revealed a mass lesion in the upper left lung lobe. After admission to our clinic, needle aspiration of left supraclavicular lymph node and bronchoscopic biopsy from upper lobe bronchus showed a non-small lung cancer; adenocarcinoma. Brain MRI was normal. PET CT revealed multiple bone metastases. Multidisciplinary Tumor Committee at our hospital referred her to the Oncology Department as an advanced stage IV disease. Chemotherapy was administered with paclitaxel and carboplatin for a total of 12 weeks. Reassessment of the patient revealed new bone metastases and crizotinib was administered since her tumor was found positive for EML4-ALK mutations. The treatment was well tolerated. During a follow up period of 6 months her clinical condition was stable and no adverse events were encountered.
authors.affiliation: Pulmonology Department, Maltepe University Hospital, Istanbul, Turkey. nessariman@yahoo.com
authors.forename: Nesrin
authors.initials: N
authors.lastname: Sarıman
authors.forename: Ender
authors.initials: E
authors.lastname: Levent
authors.forename: Neşe Arzu
authors.initials: NA
authors.lastname: Yener
authors.forename: Alpay
authors.initials: A
authors.lastname: Orki
authors.forename: Attila
authors.initials: A
authors.lastname: Saygı
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary; D001999:Bronchoscopy; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000188:drug therapy; D047928:Premature Birth / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: C522504:EML4-ALK fusion protein, human; D015514:Oncogene Proteins, Fusion; D016190:Carboplatin; D017239:Paclitaxel