We report the case of a 15-year-old girl with a large gluteal and perineal rhabdomyosarcoma diagnosed at 24 weeks of pregnancy, whose management posed a great clinical dilemma for us. The patient refused to consider a therapeutic abortion, so we opted for a customized treatment with mild doses of chemotherapy administered weekly to control tumor growth while minimizing fetal and perinatal complications. After the delivery of a healthy female, we adopted a more intensive chemotherapy regimen plus irradiation. Despite an initially good response, the disease unfortunately progressed and the patient died of her disease.
DoneganWl: Cancer and pregnancy.CA Cancer J Clin, 33: 194–214, 1983.
2.
BisognoG., FerrariA., BergeronC., ScagnellatoA., PreteA., AlaggioR., CasanovaM., D'AngeloP., Di CataldoA., CarliM.: The IVADo regimen: a pilot study with ifosfamide, vincristine, actinomycin D, and doxorubicin in children with metastatic soft tissue sarcoma.Cancer, 103: 1719–1724, 2005.
3.
RiesL.A.G., SmithM.A., GurneyJ.G., LinetM., TamraT., YoungJ.L., BuninGR (Eds): Cancer Incidence and survival among children and adolescents: United States SEER Program 1975–1995.National Cancer Institute, SEER Program, NIH Pub. No. 99–4649, Bethesda, MD, 1999.
ZemlickisD., LishnerM., DegendorferP., PanzarellaT., SutcliffeS.B., KorenG.: Fetal outcome after in utero exposure to cancer chemotherapy.Arch Intern Med, 152: 573–576, 1992.
7.
CardonickE., IacobucciA.: Use of chemotherapy during human pregnancy.Lancet, 5: 283–291, 2004.
8.
SoroskyJ.L., SoodA.K., BuekersT.E.: The use of chemotherapeutic agents during pregnancy.Obstet Gynecol Clin North Am, 24: 591–599, 1997.
9.
BuekersT.E., ThomasL.: Chemotherapy in pregnancy.Obstet Gynecol, 25: 323–327, 1998
PeresR.M., SanseverinoM.T., GuimaraesJ.L., CoserV., GiulianiL., MoreikaR.K., OrnstenT., Schuller-FacciniL.: Assessment of fetal risk associated with exposure to cancer chemotherapy during pregnancy. A multicenter study.Braz J Med Biol Res, 34: 1551–1559, 2001.
12.
MartinD., WinterS.S., GardnerM.O., NicklausP.: Rhabdomyosarcoma treated with chemotherapy during the third trimester.Obstet Gynecol, 89: 828–831, 1997.
