Placental metastases from bronchial carcinoma

Placental pathology in cancer during pregnancy and after cancer treatment exposure

Cancer during pregnancy has been associated with (pathologically) small for gestational age offspring, especially after exposure to chemotherapy in utero. These infants are most likely growth restricted, but sonographic results are often lacking. In view of the paucity of data on underlying pathophysiological mechanisms, the objective was to summarize all studies investigating placental pathology related to cancer(treatment). A systematic search in PubMed/Medline, Embase (OVID) and SCOPUS was conducted to retrieve all studies about placental pathology in cancer during pregnancy or after cancer treatment, published until August 2020. The literature search yielded 5784 unique publications, of which 111 were eligible for inclusion. Among them, three groups of placental pathology were distinguished. First, various histopathologic changes including maternal vascular malperfusion have been reported in pregnancies complicated by cancer and after cancer treatment exposure, which were not specific to type of cancer(treatment). Second, cancer(treatment) has been associated with placental cellular pathology including increased oxidative damage and apoptosis, impaired angiogenesis and genotoxicity. Finally, involvement of the placenta by cancer cells has been described, involving both the intervillous space and rarely villous invasion, with such fetuses are at risk of having metastases. In conclusion, growth restriction is often observed in pregnancies complicated by cancer and its cause can be multifactorial. Placental histopathologic changes, cellular pathology and genotoxicity caused by the cancer(treatment) may each play a role.

Metastatic pulmonary adenocarcinoma to placenta and pleural fluid: clinicopathologic findings

OBJECTIVES

To report the clinicopathologic findings of a pregnant woman with Stage IV adenocarcinoma of the lung with placental metastasis.

MATERIALS AND METHODS

Medical records review.

RESULTS

A 31-year-old G(2)P(1001) woman was diagnosed with Stage IV metastatic adenocarcinoma of the lung. At 34 weeks' and 2 days' gestation, she went into preterm labor and delivered a live male infant, weighing 2595 grams, with Apgar scores of 9 and 9, respectively. Placental pathology was significant for adenocarcinoma with a solid and acinar pattern, consistent with that from the lung. Her postpartum course was uneventful. She did not receive chemotherapy and expired one month postpartum. To date, the infant is without evidence of disease.

CONCLUSIONS

The occurance of lung cancer in pregnancy is rare and a few cases have been reported in literature. Placental metastasis is extremely uncommon in these cases and can lead to fetal involvement by lung tumor. It is important to report all cases of lung cancer occurring in pregnancy with subsequent close clinical surveillance of the infant as all cases have a different clinical picture.

Métastases placentaires de cancers maternels: revue de la littérature

The purpose of this paper was to update and analyse all the reported cases of placental metastasis. These tumours are rare and seem to complicate aggressive or disseminated malignant melanomas, leukaemias, breast cancers and lung cancers. Maternal prognosis is poor. The risk factors of cancer in the newborn are unknown. In a pregnant woman with a history of malignancy, a systematic histological examination of the placenta for evidence of metastasis is required. Close observation and follow-up of the infant has to be recommended, especially in case of placental involvement. To estimate the incidence of placental metastases and to improve knowledge of their natural history, the creation of registries of malignancies associated with pregnancy is required.

Anaesthesia for caesarean section in a woman with lung cancer: case report and review

A 33-year-old woman pregnant with twins was diagnosed with metastatic lung cancer during pregnancy. Her multidisciplinary care raised many medical and ethical issues. To help decide on the best anaesthetic technique for caesarean section, a literature search of published case reports of pregnancy associated with lung cancer was performed. Thirty-five cases of primary lung cancer associated with pregnancy were found. Anaesthetic technique was reported in only five of the 20 patients who underwent caesarean section: one spinal, three epidurals and one general anaesthetic. Of the 11 patients who delivered vaginally, only one was reported to have received epidural analgesia. As published data regarding anaesthesia and analgesia are limited for women with lung cancer in pregnancy, we describe our perioperative approach and review the potential challenging aspects of management in a pregnant patient with metastatic lung cancer.