Medicine and Health Sciences Commons^™

Juvenile Granulosa Cell Tumor In An Adult Woman During Pregnancy: A Case Report And Review Of The Literature, Mackenzie Cummings, Pamela Edmonds, Mark S. Shahin, Joe I. Sorosky

Abington Jefferson Health Papers

Objective

To report a case of stage IIIB juvenile granulosa cell tumor (JGCT) complicating pregnancy in a 33 year-old (y.o.) woman.

Methods

Retrospective review of the clinical data, imaging studies, and pathology reports of a case of JGCT diagnosed during pregnancy. Patient consent was obtained for review and presentation of the case. A literature review was conducted.

Results

A 33 y.o., gravida 3, para 1 was incidentally found to have an 8 cm left ovarian mass on an anatomy scan at 22 weeks gestation. Four days later, she presented to labor and delivery triage with abdominal pain. An ultrasound revealed …

In Utero Exposure To Antiemetic And Risk Of Adult-Onset Colorectal Cancer, Caitlin C Murphy, Piera M Cirillo, Nickilou Y Krigbaum, Amit G Singal, Barbara A Cohn

Journal Articles

BACKGROUND: Incidence rates of colorectal cancer (CRC) are increasing among adults born in and after the 1960s, implicating pregnancy-related exposures introduced at that time as risk factors. Dicyclomine, an antispasmodic used to treat irritable bowel syndrome, was initially included in Bendectin (comprising doxylamine, pyridoxine, and dicyclomine), an antiemetic prescribed during pregnancy in the 1960s.

METHODS: We estimated the association between in utero exposure to Bendectin and risk of CRC in offspring of the Child Health and Development Studies, a multigenerational cohort that enrolled pregnant women in Oakland, CA, between 1959 and 1966 (n = 14 507 mothers and 18 751 …

Juvenile-Type Granulosa Cell Tumor In Pregnancy Presenting As A Ruptured Abdominal Mass, Odinaka Mogor, Steven Feinstein, Glen Friedman, Jose Salvador Saldivar, Melissa Mendez

HCA Healthcare Journal of Medicine

Introduction

Granulosa cell tumors (GCTs) are part of the sex cord-stromal tumors occurring with a rare incidence rate that only makes up about 2-5% of all ovarian malignancies.

Case Presentation

A 28-year-old woman, gravida 2, para 1, presented with a juvenile-type granulosa cell tumor at 31 weeks gestation, which appeared as a rapidly growing mass with rupture. She underwent an exploratory laparotomy with unilateral salpingo-oophorectomy, and consequently had a successful vaginal delivery. Post-operatively she was treated with paclitaxel and carboplatin chemotherapy regimen with no evidence of recurrence after one year.

Conclusion

Radical surgical management is recommended for these tumors due …

Disparities In The Use Of Assisted Reproductive Technologies After Breast Cancer: A Population-Based Study, Clare Meernik, Kirsten Jorgensen, Chi-Fang Wu, Caitlin C Murphy, Valerie L Baker, Paula C Brady, Roni Nitecki, Hazel B Nichols, J Alejandro Rauh-Hain

Journal Articles

PURPOSE: Equitable access to oncofertility services is a key component of cancer survivorship care, but factors affecting access and use remain understudied.

METHODS: to describe disparities in assisted reproductive technology (ART) use among women with breast cancer in California, we conducted a population-based cohort study using linked oncology, ART, and demographic data. We identified women age 18-45 years diagnosed with invasive breast cancer between 2000 and 2015. The primary outcome was ART use-including oocyte/embryo cryopreservation or embryo transfer-after cancer diagnosis. We used log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) to identify factors associated with ART …

Disparities In Fertility-Sparing Treatment And Use Of Assisted Reproductive Technology After A Diagnosis Of Cervical, Ovarian, Or Endometrial Cancer, Kirsten Jorgensen, Clare Meernik, Chi-Fang Wu, Caitlin C Murphy, Valerie L Baker, Peiton Jarmon, Paula C Brady, Roni Nitecki, Hazel B Nichols, Jose Alejandro Rauh-Hain

Journal Articles

OBJECTIVE: to assess the presence of sociodemographic and clinical disparities in fertility-sparing treatment and assisted reproductive technology (ART) use among patients with a history of cervical, endometrial, or ovarian cancer.

METHODS: We conducted a population-based cohort study of patients aged 18-45 years who were diagnosed with cervical cancer (stage IA, IB), endometrial cancer (grade 1, stage IA, IB), or ovarian cancer (stage IA, IC) between January 1, 2000, and December 31, 2015, using linked data from the CCR (California Cancer Registry), the California Office of Statewide Health Planning and Development, and the Society for Assisted Reproductive Technology. The primary outcome …

An International Real-World Analysis Of Relapsed/Refractory Lymphoma Occurring During Pregnancy, Faheem Farooq, Justin S. Brandt, Elyce Cardonick, Evgeniya Polushkina, Julie M. Vose, Sairah Ahmed, Praveen Ramakrishnan Geethakumari, Adam J. Olszewski, Hesham Yasin, Umar Farooq, Nada Hamad, Yong Lin, Charlotte Maggen, Robert Fruscio, Mina Mhallem Gziri, Karina Dahl Steffensen, Frédéric Amant, Andrew M. Evens

Journal Articles: Oncology and Hematology

No abstract provided.

Use Of Thrombopoietin Receptor Agonists In Pregnancy: A Review Of The Literature, Jude Howaidi, Abdullah M. Alrajhi, Ali Howaidi, Fouad H. Alnajjar, Imran K. Tailor

Hematology/Oncology and Stem Cell Therapy

The management of immune thrombocytopenic purpura (ITP) involves several lines of therapy such as corticosteroids and intravenous immunoglobulin. With the emergence of novel therapies such as thrombopoietin receptor agonists (TPO-RAs), there has been a shift in treatment modalities. Eltrombopag and romiplostim have proven to be effective in the management of ITP through clinical studies, but their safety in pregnancy remains uncertain. The purpose of the study is to review the literature to evaluate the safety of TPO-RAs in pregnant women. Ten case reports and a cohort study pertaining to the use of TPO-RAs in pregnancy were obtained. According to the …

Impact Of Pregnancy On Cancer Survival: Experience At A Tertiary Care Hospital, Dur-E- Shahwar, Sheikh Irfan, Zaheena Islam, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Objectives: To assess the overall survival of pregnant women diagnosed with cancer during pregnancy or became pregnant thereafter.
Methods: A retrospective medical record review of 90 patients who were diagnosed with cancer when pregnant or who became pregnant thereafter between 1996 and 2015 in Aga Khan University Hospital, Karachi.
Results: A total of 90 patients were analyzed. The malignancies that expectant mothers had were, breast cancer 38 (42.2%), hematological cancers 29 (32.2%), brain cancer 10 (11.1%), and other malignancies 13 (14.4%) that included thyroid cancers, gestational trophoblastic disease and synovial tumor of foot. We observed only four deaths out of …

Diffuse Intrasinusoidal Hepatic Metastasis From Breast Cancer Presenting As Liver Failure: Effective And Rapid Treatment With Weekly Low-Dose Adriamycin, Thanh-Phuong N. Afiat, Timothy N. Hembree, Erin A. Dean, Cyrillo Araujo, Luis R. Pena, Marilin Rosa, Hyo S. Han, Kaitlin Hendrix, Asha Ramsakal

Oncologic Sciences Faculty Publications

Background: Hepatic metastasis is well known in breast cancer. Approximately 12–20% of breast cancer patients will develop liver metastasis, which usually presents as discrete mass lesions. Rarely, metastatic spread can be so diffuse that it is unidentifiable on imaging but can progress to fulminant hepatic failure. Our case report suggests that clinicians need to have a high index of suspicion when patients present with rapidly decompensating liver failure in the absence of discrete radiologic hepatic lesions, and that weekly Adriamycin should be considered as a first-line therapeutic option.

Case Report: A 28-year-old African American woman with a history of locally …

Chemotherapy Is Avoided During The First Trimester Of Pregnancy, When Is The Safest Time To Start Treatment During The Second Or Third Trimester?, Elyce Cardonick, Emily Eicheldinger, John P. Gaughan

Cooper Medical School of Rowan University Faculty Scholarship

ABSTRACT

Background

Cancer occurs in approximately 1:1000 pregnancies. When chemotherapy cannot be delayed until postpartum, beginning chemotherapy is based on presumed safety after organogenesis is completed during the first trimester. The safest gestational age to start chemotherapy after the first trimester is unknown.

Patients and Methods

In an observational cohort of pregnant women diagnosed and treated for cancer at multiple centers, pregnancy outcomes for the mother, and clinical outcomes for the neonate were analyzed according to the gestational age in weeks of pregnancy at first chemotherapy cycle. Outcomes including birth weight, fetal growth restriction, congenital malformations, and perinatal complications for …

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Senior Honors Theses

Women's health care professionals, such as general physicians, obstetricians and gynecologists, midwives, nurses, and doulas, in the US need to be aware of cultural issues and disparities. Minorities and migrant women experience cultural challenges and disparities when receiving health care in the US. Without cultural sensitivity, patient care is compromised. Pregnancy and childbirth practices vary widely by culture, and potential differences in perspectives, beliefs, and treatment of these are critical issues for women’s health care professionals to study. Female genital cutting (FGC), obstetric fistulas (OF), and female cancer are also discussed in this paper.

Anaemia In Pregnancy: Occurrence In Two Economically Different Clinic Populations Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, Javed H. Rizvi

Mohammad Khurshid

According to previous WHO standards, anaemia in pregnancy denoted a haemoglobin level of 11.0 gms/dl or less, but this is now considered to be variable1 as it differs from country to country depending on local reference ranges and socio-economic conditions. Each country should “lay down minimal acceptable standards” below which an individual is considered to be anaemic, taking into account the available fmancial and manpower resources and other health needs of the country2. There is a wide divergence in the quoted prevalence of anaemia in Pakistan and neigh­bouring countries.3-6 This study was undertaken to determine a range of haemoglobin levels …

Is Pregnancy-Associated Melanoma Associated With Adverse Outcomes?, Maris S Jones, Jihey Lee, Stacey L Stern, Mark Faries

Articles, Abstracts, and Reports

BACKGROUND: Melanoma is the most common malignancy encountered during pregnancy. Conflicting data have led to ongoing confusion regarding pregnancy-associated melanoma (PAM) in the media and among the public. The objective of this study was to better characterize both the clinical presentation of PAM and its prognostic implications.

STUDY DESIGN: Female patients of reproductive age, with stage 0 to IV cutaneous melanoma, were identified from our prospectively maintained database. Clinical and histopathologic factors were analyzed with appropriate statistical methods. Univariable and then multivariable analysis were used on matched data to compare disease-free survival (DFS), overall survival (OS), and melanoma-specific survival (MSS) …

Sex-Specific Associations Of Maternal Birthweight With Offspring Birthweight In The Omega Study., Collette N Ncube, Amelia R Gavin, Michelle A Williams, Chunfang Qiu, Tanya K Sorensen, Daniel A Enquobahrie

Articles, Abstracts, and Reports

PURPOSE: We investigated nonlinear and offspring sex-specific associations of maternal birthweight (BW) with offspring BW among participants of the Omega study, a pregnancy cohort.

METHODS: Maternal BW was modeled as a continuous variable, linear spline and binary variable indicating low birthweight (LBW;≥2500 grams). Offspring BW was modeled as a continuous and binary variable in regression models. Nonlinearity was assessed using likelihood ratio tests (LRTs) in marginal linear spline models.

RESULTS: For every 100-gram increase of maternal BW, offspring BW increased by 22.29 (95% CI: 17.57, 27.02) or 23.41 (95% CI: 6.87, 39.96) grams among mothers with normal BW or born …

Cancer Diagnosis During Pregnancy: Evaluating The Challenges Faced By Oncologists, Shannon Kaye Mulligan

Dissertations & Theses (Open Access)

Cancer during pregnancy is occurring more often than in the past, and it is estimated that cancer is diagnosed in approximately 1/1000 pregnancies. A consensus exists that management of these patients should prioritize survival of the mother and minimize teratogenic effects to the fetus, and utilize a multidisciplinary approach, involving medical oncology, surgical oncology, radiation oncology, radiology, and a maternal fetal medicine specialist. In spite of this consensus, there is not a standardized approach for treating cancer in women diagnosed during pregnancy. Due to the relative infrequency of this situation in the oncologic setting, the aims of this study were …

Oncolog, Volume 36, Issue 02, April-June 1991, Gilbert H. Fletcher M.D., James M. Bowen

OncoLog MD Anderson's Report to Physicians (All issues)

• Redefining the risks of chemotherapy during pregnancy Renewing the assault on pancreatic cancer
• Significance of cancer volume in radiotherapy

Rubella Susceptibility And Continuing Risk Of Infection In Pregnancy, Saadiya Rasul, Mohammad Khurshid, Javaid Rizvi, Shahbanu Rizvi

Section of Haematology/Oncology

Sera of 2000 pregnant women attending the antenatal clinic of the Aga Khan University Hospital were tested for rubella antibodies. Of these 1684(84.2%) were Immune and 316(15.8%) were susceptible to rubella. Majority (99.8%) of the women were Asian in origin. Susceptibility decreased with increasing age and parity. We conclude that apart from vaccination of all young children greater attention should be paid to immunization of women of child-bearing age

Anaemia In Pregnancy: Occurrence In Two Economically Different Clinic Populations Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, Javed H. Rizvi

Section of Haematology/Oncology

According to previous WHO standards, anaemia in pregnancy denoted a haemoglobin level of 11.0 gms/dl or less, but this is now considered to be variable¹ as it differs from country to country depending on local reference ranges and socio-economic conditions. Each country should “lay down minimal acceptable standards” below which an individual is considered to be anaemic, taking into account the available fmancial and manpower resources and other health needs of the country². There is a wide divergence in the quoted prevalence of anaemia in Pakistan and neigh­bouring countries.^3-6 This study was undertaken to determine a …