Magenkarzinom in der Schwangerschaft - Ein Fallbericht

Zusammenfassung

Die Symptome „Übelkeit und Erbrechen” werden bei Schwangeren selten mit der Differenzialdiagnose eines Magenkarzinoms in Verbindung gebracht, da diese Erkrankung nur mit einer Wahrscheinlichkeit von 0,1 % in der Gravidität auftritt. Die Verkennung der Symptome führt - verglichen mit Nicht-Schwangeren - zu einer verzögerten Diagnose. Im fortgeschrittenen Stadium ist meist nur noch ein palliatives Vorgehen möglich. Eine Gefährdung des Feten durch Metastasierung gilt als weitgehend ausgeschlossen; daher ist unter palliativen Bedingungen ein abwartendes Vorgehen gerechtfertigt. Nach Erreichen der fetalen Lebensreife sollte die Schnittentbindung mit anschließender Chemotherapie erfolgen. Ziel sollte es sein, bei entsprechenden Symptomen an ein Magenkarzinom zu denken und es frühzeitig zu diagnostizieren. Denn nur bei lokal begrenztem Tumorleiden ist eine R0-Resektabilität möglich, welche ein gutes Langzeit-Überleben der Patientin sichert.

Abstract

Nausea and vomiting are common sufferings of pregnant woman. No gynaecologist would consider carcinoma of the stomach as a probable differential diagnosis according the extremely rare probability of this disease during pregnancy. Consequently, a late diagnosis in pregnancy can result in spreading throughout the whole abdomen. In this advanced stage, it is only possible to recommend palliative care to the patient followed by short survival. Fetal metastasis is a rare entity, therefore caesarean section and chemotherapy should not be performed until fetal maturity. If vomiting and nausea are prolonged after the sixteenth week of pregnancy a malignant disease of the stomach should be excluded. Only in case of short delay between symptoms and diagnosis, the stomach cancer can be resected totally followed by a better overall survival of the patient.

Schwangerschaft - Übelkeit und Erbrechen - Magenkarzinom

pregnancy - nausea - vomiting - gastric cancer

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