PDF(Pubmed)
Abstract：
Pregnancy-associated gastric cancer is extremely rare. In many cases, the cancer is already advanced at the time of diagnosis, and the prognosis is often poor. A 39-year-old primigravida, with dichorionic diamniotic twins, was admitted to our hospital for threatened preterm labor at 31 weeks of gestation. At 32 weeks of gestation, she developed a fever and tested positive for influenza A. She recovered from influenza A on the following day but had an emergency cesarean section for premature rupture of the membranes at 32 weeks of gestation. She was discharged on postpartum day six. Thereafter, she was again infected with influenza A. On day 18, she underwent an abdominal ultrasound revealing multiple mass lesions in the liver, because she had an uncomfortable upper gastric with persistent fever. She was referred to the internal medicine team, who made a diagnosis of stage IV gastric cancer. Importantly, non-specific symptoms and physical signs that are not explicable by the normal course of pregnancy may be recognized through conscientious history-taking and physical observations. If gastrointestinal symptoms are prolonged, or if symptoms such as severe weight loss, melena, a tender abdominal mass, or persistent and unexplained fever develop, an endoscopic assessment should be conducted to suspect other diseases. In addition, proactive ultrasound scanning, including the upper abdomen, may detect pregnancy-associated gastric cancer and lead to further in-depth investigations.
摘要：
妊娠相关胃癌极为罕见。在许多情况下,癌症在诊断时已经进展，预后往往较差。39岁的primigravida,与双绒毛膜羊膜双胞胎，在妊娠31周时因先兆早产入院。妊娠32周时,她发烧，甲型流感检测呈阳性。第二天，她从甲型流感中康复，但在妊娠32周时因胎膜早破进行了紧急剖宫产。她在产后第六天出院。此后,她再次感染甲型流感。在第18天，她接受了腹部超声检查，发现肝脏有多个肿块，因为她上胃不舒服，持续发烧。她被转介到内科小组，诊断为IV期胃癌.重要的是,正常妊娠过程无法明确的非特异性症状和体征可以通过认真的病史记录和身体观察来识别.如果胃肠道症状延长，或者如果出现严重体重减轻等症状，Melena,一个柔软的腹部肿块，或持续和无法解释的发烧，应进行内窥镜检查以怀疑其他疾病。此外,主动超声扫描，包括上腹部,可能会发现妊娠相关胃癌，并导致进一步的深入研究。
