Cancer of unknown primary during pregnancy: an exceptionally rare coexistence

Anticancer Res. 2015 Jan;35(1):575-9.

Abstract

Background: Cancer in pregnancy is a rare disease with breast cancer, cervical cancer, melanoma and Hodgkin's disease to be the most commonly diagnosed malignancies during gestation. Cancer of unknown primary (CUP) is a well-recognized clinical disorder where the primary site can not be identified after a standard diagnostic approach. CUP in pregnancy has rarely been described.

Materials and methods: We searched MEDLINE and contacted cancer Centers in Europe, United States and Australia where patients with CUP or pregnant patients with cancer were diagnosed and treated.

Results: Since 1976 we identified 18 pregnant women with CUP in a median gestational age of 34 weeks. Most of these patients were diagnosed with poorly-differentiated histology, had poor response to systemic treatment and a median maternal survival of 8 months. Seventy-two percent of mothers have died, while 80% of the newborns were alive and healthy. Almost one fourth of placentas examined showed metastatic disease.

Conclusion: CUP during pregnancy is a very rare coexistence, usually has an aggressive disease with poor response to chemotherapy and a dismal prognosis. Both obstetricians and oncologists should be aware of this rare condition.

Keywords: Cancer of unknown primary; placental in-vasion; pregnancy; prognosis; review; treatment.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Live Birth
  • Neoplasms, Unknown Primary / mortality*
  • Neoplasms, Unknown Primary / therapy
  • Pregnancy
  • Pregnancy Complications, Neoplastic / mortality*
  • Pregnancy Complications, Neoplastic / therapy
  • Survival Rate
  • Treatment Outcome