title: Cancer of unknown primary during pregnancy: an exceptionally rare coexistence.
abstract: BACKGROUND
  Cancer in pregnancy is a rare disease with breast cancer, cervical cancer, melanoma and Hodgkin's disease to be the most commonly diagnosed malignancies during gestation. Cancer of unknown primary (CUP) is a well-recognized clinical disorder where the primary site can not be identified after a standard diagnostic approach. CUP in pregnancy has rarely been described.
  
  
  METHODS
  We searched MEDLINE and contacted cancer Centers in Europe, United States and Australia where patients with CUP or pregnant patients with cancer were diagnosed and treated.
  
  
  RESULTS
  Since 1976 we identified 18 pregnant women with CUP in a median gestational age of 34 weeks. Most of these patients were diagnosed with poorly-differentiated histology, had poor response to systemic treatment and a median maternal survival of 8 months. Seventy-two percent of mothers have died, while 80% of the newborns were alive and healthy. Almost one fourth of placentas examined showed metastatic disease.
  
  
  CONCLUSIONS
  CUP during pregnancy is a very rare coexistence, usually has an aggressive disease with poor response to chemotherapy and a dismal prognosis. Both obstetricians and oncologists should be aware of this rare condition.
authors.affiliation: Department of Medical Oncology, Ioannina University Hospital, Ioannina, Greece npavlid@uoi.gr.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Pavlidis
authors.affiliation: Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: Fedro
authors.initials: F
authors.lastname: Peccatori
authors.affiliation: Medical Oncology Department, St Georges' Hospital, London, U.K.
authors.forename: Fiona
authors.initials: F
authors.lastname: Lofts
authors.affiliation: Sarah Cannon Cancer Center and Research Institute, Tennessee Oncology, PLLC, Nashville, TN, U.S.A.
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Greco
mesh_terms: D005260:Female; D006801:Humans; D050498:Live Birth; D009382:Neoplasms, Unknown Primary / Q000401:mortality* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cancer of unknown primary; placental in-vasion; pregnancy; prognosis; review; treatment