Mucinous Ovarian Cancer Treated During Pregnancy

What happened, in summary

A 25-year-old woman was 6 weeks pregnant when she developed severe lower abdominal pain. Emergency surgery for a twisted ovarian mass removed the left ovary and fallopian tube and a cyst from the right ovary. Pathology unexpectedly showed grade 1 mucinous ovarian carcinoma with an intact capsule. The cancer was documented as at least Stage I.

Because she strongly wanted to continue the pregnancy, she declined another staging operation and chemotherapy at that time. At 39 weeks, she returned with abdominal bloating and a new 12 x 11 cm pelvic mass that was suspected to be recurrent ovarian cancer. During cesarean delivery, the isolated tumor was removed, followed by cytoreductive surgery including hysterectomy, removal of the remaining ovary and fallopian tube, omentectomy, and lymph node surgery. Pathology confirmed metastatic ovarian cystadenocarcinoma in the pelvic tumor, while the examined lymph nodes and other removed tissues were negative.

After delivery and surgery, she completed 6 courses of cisplatin and docetaxel chemotherapy. Her baby was born in good condition. The mother and child were followed for more than 5 years, during which the woman had no evidence of tumor recurrence and the child showed normal physical and neurological development. Her story centers on balancing cancer treatment with continuation of an early pregnancy and then treating an isolated recurrence after delivery.