title: Management of musculoskeletal tumors during pregnancy: a retrospective study.
abstract: BACKGROUND
  In recent years, scientific research has increasingly focused on malignancies during pregnancy. However, the development of musculoskeletal tumors during pregnancy has only been the subject of a few studies so far. The primary aim of this study was to identify the incidence of sarcomas during pregnancy at our musculoskeletal tumor center (MSTC). Secondarily we intended to analyze these cases and discuss possible recommendations regarding diagnostic work-up as well as therapy on the basis of the literature.
  
  
  METHODS
  All female patients who had been treated for soft tissue or bone sarcoma at our academic MSTC in the period between the years 2002 and 2010 were screened retrospectively for anamnestic annotations of pregnancy or records of pregnancy in the obstetrical database of our university hospital. The patients who met the criteria for inclusion (diagnosed sarcoma and pregnancy) were enrolled. For every pregnant patient two age-matched female control patients that suffered from tumors with the same histologic type were included.
  
  
  RESULTS
  In the period between 2002 and 2010, 240 female patients between the age of 16 and 45 were treated for sarcoma. In eight out of the 240 cases the tumor disease developed or progressed during pregnancy. The delay in diagnosis was approximately eight months and turned out to be significantly higher for pregnant patients compared to non- pregnant controls. Each woman's tumor was misdiagnosed at least once.
  
  
  CONCLUSIONS
  Diagnostic follow-up of pregnant women presenting with a growing or painful mass, which is suspected to be a musculoskeletal tumor, should be performed at a specialized tumor center. We recommend a multidisciplinary approach and discussing all possible consequences for mother and child intensively in accordance with the available literature.
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675, Munich, Germany. lukas.postl@tum.de.|Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. lukas.postl@tum.de.
authors.forename: Lukas K
authors.initials: LK
authors.lastname: Postl
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. ggradl@mac.com.
authors.forename: Guntmar
authors.initials: G
authors.lastname: Gradl
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. eisenhart-rothe@ortho.med.tum.de.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Eisenhart-Rothe
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. andreastoepfer@t-online.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Toepfer
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. florian.pohlig@mri.tum.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Pohlig
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. burgkart@tum.de.
authors.forename: Rainer
authors.initials: R
authors.lastname: Burgkart
authors.affiliation: Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. rechl@ortho.med.tum.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Rechl
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675, Munich, Germany. chlodwig.kirchhoff@mri.tum.de.
authors.forename: Chlodwig
authors.initials: C
authors.lastname: Kirchhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D024221:Antineoplastic Protocols; D001859:Bone Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D019468:Disease Management; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010348:Patient Care Team / Q000458:organization & administration; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D061665:Time-to-Treatment