title: Rectal cancer in pregnancy: a diagnostic and therapeutic challenge.
abstract: BACKGROUND
  The occurrence of colorectal cancer during pregnancy is rare and is associated with diagnostic and therapeutic challenges. Herein, we report such a case of rectal cancer in pregnancy and review the literature.
  
  
  METHODS
  A 31-year-old multiparous, pregnant woman, in the 20th week of gestation, presented with rectal bleeding progressing to spasmodic abdominal pain and right flank vague pain. A flexible rectosigmoidoscopy showed a large ulcerative mass located in the rectosigmoid junction, 15 cm away from anal verge. Imaging studies and biopsy proved it to be rectal adenocarcinoma with single liver metastasis. The patient's pregnancy was terminated and neoadjuvant therapy followed by curative surgery was performed. She is currently receiving adjuvant systemic therapy to eradicate potential micrometastatic disease.
  
  
  CONCLUSIONS
  This case suggests that colorectal cancer can mimic the signs and the symptoms of pregnancy and tends to present at an advanced stage in pregnant women.
authors.affiliation: Department of Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Monireh
authors.initials: M
authors.lastname: Toosi
authors.affiliation: Student Research Committee, Resident of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Moaddabshoar
authors.affiliation: Organ Transplant Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malek-Hosseini
authors.affiliation: Medical Imaging Research Center, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Sasani
authors.affiliation: Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Maral
authors.initials: M
authors.lastname: Mokhtari
authors.affiliation: Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: mohpanah@sums.ac.ir.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mohammadianpanah
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Diagnosis; Pregnancy; Prognosis; Rectal cancer; Treatment