| Popis: |
Purpose Thirty year old woman with progressed thoracic carcinoid tumor, hoped for new baby and experienced pregnancy, delivery and raising during chemotherapy. Reviewing the cancer treatment and daily living, medical and social resources for the patient are discussed. Clinical course Unmarried mother of a child and working was introduced and visit hospital for investigation of chest pain for 3 years. CT image showed the multiple nodules in lung anterior mediastinum, pleura and liver. With liver biopsy, patient was diagnosed as progressed carcinoid tumor. Tumor was primary of lung or thymus, and stage T4N3M1c 4B. PS1 and without special complication, patient wished the aggressive treatment continuing raising and working. From the first, she wanted new baby with new partner. She was treated with afinitol carboplatin and nab-paclitaxel for 3 months. While prolonged interval of chemotherapy due to myelosuppression, she revealed pregnant of 6-7 weeks. Consulting with gynecologist, nurses of several developments, social workers, she developed pregnancy. On 36 weeks of pregnancy, she acute admitted with water breaking and delivered by Caesarean section. Dealing several problems such as departure from partner, raising children by herself, worsening pain and difficulty of usual social life, she restarted chemotherapy again 2 months later with nab-paclitaxel and irinotecan for 3 months. However, complication with cholangitis, poor response, no enough time for her cancer therapy, we decided best palliative care. She died one year after childbirth. Discussions With many supports, chemotherapy before pregnant, delivery and raising children was so good. But more improvements of cancer care were needed especially after child birth. |
