caa a22 4500 606240640 CHVBK 20210128101309.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00508-015-0726-6 doi (NATIONALLICENCE)springer-10.1007/s00508-015-0726-6 Lung cancer in pregnancy [Elektronische Daten] [Kornelia Holzmann, Roland Kropfmüller, Herwig Schinko, Stephan Bogner, Franz Fellner, Wolfgang Arzt, Bernd Lamprecht] Summary: In the 26th week of gestation, a 29-year-old pregnant office employee was referred to the pulmonary department of Linz General Hospital (AKH) under the suspicion of tuberculosis. She complained of a cough with intermittent hemoptysis and pain in the thoracic spine from which she had been suffering the past 9 weeks. A plain chest X-ray showed a dense infiltrate on the right side and multiple smaller shadows in both lungs. Laboratory testing revealed anemia, leukocytosis, and an increase of C-reactive protein. All tests for tuberculosis were negative. A bronchoscopy was performed and biopsies were taken from the right upper and middle lobe. The histopathological examination found cells of an adenocarcinoma. A magnetic resonance imaging (MRI) revealed a large tumor and surrounding atelectasis were seen in the right upper and middle lobe, as well as multiple intrapulmonary metastases in both lungs. In addition, not only metastases in the thoracic spine (level Th2/3) but also at other osseous locations and multiple cerebral metastases were detected. The patient received one cycle of chemotherapy consisting of docetaxel and carboplatin (AUC5) in the 27th week of gestation. Additional radiotherapy was applied to the involved thoracic spine. Due to positive epidermal growth factor receptor mutation, therapy with gefitinib 250mg/day was started 2 days after a Caesarean section (preceded by treatment for fetal lung maturation). A healthy girl was delivered in the 30th week of pregnancy. Staging with computed tomography (CT) after delivery revealed an unstable fracture of Th2 with compression of the spinal cord. Neurosurgery was performed, consisting of a ventral corporectomy of Th1-2 followed by an anterior and posterior osteosynthesis for stabilization. The patient was discharged without neurological deficits within 1 week. Subsequent treatment with gefitinib improved the performance status of the patient, and CT scans of the chest and an MRI of the brain showed the size of the tumor to be shrinking. Meanwhile, the infant developed appropriately for her age. After 14 months of the first diagnosis, the patient experienced neurological symptoms (aphasia, confusion) due to neoplastic meningeosis and cerebral venous sinus thrombosis together with local tumor progression in the lung. One course of chemotherapy, combining carboplatin/pemetrexed/bevacizumab, was given without clinical response. Despite best supportive care, the patient died 17 months after diagnosis in October 2013. Springer-Verlag Wien, 2015 Pregnancy nationallicence Lung cancer nationallicence Gefitinib nationallicence Chemotherapy nationallicence Radiation therapy nationallicence Holzmann Kornelia Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut Kropfmüller Roland Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut Schinko Herwig Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut Bogner Stephan Institute of Pathology, General Hospital Linz (AKH), Linz, Austria aut Fellner Franz Institute of Radiology, General Hospital Linz (AKH), Linz, Austria aut Arzt Wolfgang Institute of Prenatal Medicine, Linz, Austria aut Lamprecht Bernd Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut Wiener klinische Wochenschrift Springer Vienna 127/15-16(2015-08-01), 639-644 0043-5325 127:15-16<639 2015 127 508 https://doi.org/10.1007/s00508-015-0726-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-015-0726-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Holzmann Kornelia Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut NATIONALLICENCE 700 1- Kropfmüller Roland Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut NATIONALLICENCE 700 1- Schinko Herwig Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut NATIONALLICENCE 700 1- Bogner Stephan Institute of Pathology, General Hospital Linz (AKH), Linz, Austria aut NATIONALLICENCE 700 1- Fellner Franz Institute of Radiology, General Hospital Linz (AKH), Linz, Austria aut NATIONALLICENCE 700 1- Arzt Wolfgang Institute of Prenatal Medicine, Linz, Austria aut NATIONALLICENCE 700 1- Lamprecht Bernd Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/15-16(2015-08-01), 639-644 0043-5325 127:15-16<639 2015 127 508