J Gynecol Oncol | Volume 2, Issue 1 | Case Report | Open Access
Claire Carlier1*, Félix Felici1, Emilie Raimond2, Olivier Graesslin2, Florian Slimano3, MathildeBrasseur1, Christine Hoeffel4, Camille Boulagnon-Rombi5 and Olivier Bouché1
1Department of Ambulatory Medicine, Oncology and Hematology (UMA-CH), CHU Reims, France
2Department of Obstetrics and Gynecology, Reims-Champagne-Ardennes University, France
3Department of Pharmacy, CHU Reims, France
4Department of Radiology, CHU Reims, France
5Department of Pathology, CHU Reims, France
*Correspondance to: Claire Carlier
Fulltext PDFIntroduction: Pregnancy in cancer patient is rare and tends to produce unspecific symptoms until advanced stage. Therefore, common manifestations of ectopic pregnancy must be properly evaluated to avoid delayed diagnosis. Case: A 31 year-old woman, carrying a copper Intra Uterine Device (IUD), presented with abdominal pain and increase in pregnancy markers while she was receiving treatment for colorectal adenocarcinoma by oral chemotherapy accordingly to the stage of disease. After a positive pelvic ultrasound, Magnetic Resonance Imaging (MRI) confirmed a right adnexal mass next to the right ovary as well as abundant ascites. These findings were related to an ectopic pregnancy. Two intramuscular and one in situ methotrexate injections were performed because of the persistence of the pelvic mass and the stagnation of Beta-HCG level.
Discussion: Pregnancy during treatment of colorectal carcinoma is a rare event and its diagnosis is often delayed because symptoms are unspecific until it is advanced. Indeed, amenorrhea is a common symptom in cancer treatments due to chemotherapy. Pelvic ultrasound and MRI are the imaging modalities of choice as abdominal Computed Tomography (CT) is generally contraindicated during pregnancy. Methotrexate intramuscular injection is the gold standard treatment for ectopic pregnancy. However, in situ administration may represent an alternative.
Conclusion: Ectopic pregnancy can be a rare reason for sudden amenorrhea in a patient with colorectal cancer. The latter symptom should prompt assessment of β-HCG blood levels as well as performance of appropriate imaging, if the diagnosis is uncertain.
Ectopic pregnancy; Colorectal neoplasm; Intra uterine device
Carlier C, Felici F, Raimond E, Graesslin O, Slimano F, Brasseur M, et al. Ectopic Pregnancy Occurring Under Colorectal Cancer Treatment: A Case Report. J Gynecol Oncol. 2019; 2(1): 1007.