What happened, in summary

A 22-year-old woman had previously been treated for severe aplastic anemia with an allogeneic bone marrow transplant in February 2022. Two months later, she was diagnosed with gastric adenocarcinoma.

She underwent subtotal gastrectomy with reconstruction in May 2022 and remained cancer-free afterward. Her earlier bone marrow transplant was treatment for aplastic anemia, not for the gastric cancer.

In 2024, she conceived spontaneous twins without fertility preservation. The pregnancy required close multidisciplinary care because of her prior transplant and gastrectomy. She developed a blood clot in her leg and later severe hydronephrosis from pressure on the urinary system, both of which were treated during pregnancy.

She delivered the twins by planned cesarean section at 35 weeks and 6 days. Both babies were born in good condition. She was discharged 4 days later and reported good recovery at outpatient follow-up. Her course demonstrates a successful pregnancy after cancer-free survival following gastric surgery.