title: Ovarian cysts and cancer in pregnancy.
abstract: Adnexal masses are diagnosed in 5% pregnancies and pose diagnostic and management challenges. Ultrasound and magnetic resonance imaging (MRI) are the mainstay as an evaluation procedure; surgery is warranted for persistent masses with a diameter of >5 cm and sonographic signs of possible malignancy. Optimal timing for a planned surgery is the second trimester and does not adversely affect neonatal outcome. Laparoscopy is safe in pregnancy. Management for ovarian cancer during pregnancy should be individualised and formulated by a multidisciplinary team in a specialised centre while also considering the patients' wishes to preserve pregnancy. The following options can be considered: (i) induced abortion followed by standard management of ovarian cancer, (ii) pregnancy-preserving surgery followed by chemotherapy, planned delivery and secondary surgical completion or (iii) neoadjuvant chemotherapy followed by surgery during the postpartum period. Standard chemotherapy administered in non-pregnant population can only be used during the first trimester of pregnancy.
authors.affiliation: Tata Medical Center, 14 Main Arterial Road, Rajarhat, Kolkata 700156, India; Newcastle University, New Castle, UK. Electronic address: asima7@yahoo.co.in.
authors.forename: Asima
authors.initials: A
authors.lastname: Mukhopadhyay
authors.affiliation: Tata Medical Center, 14 Main Arterial Road, Rajarhat, Kolkata 700156, India.
authors.forename: Aditi
authors.initials: A
authors.lastname: Shinde
authors.affiliation: Northern Gynaecological Oncology Centre, Gateshead, UK.
authors.forename: Raj
authors.initials: R
authors.lastname: Naik
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D010048:Ovarian Cysts / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D010052:Ovariectomy; D019990:Perioperative Care; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D058994:Salpingectomy; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: ovarian cancer; ovarian cyst; pregnancy