Management of chemotherapy in a pregnancy complicated by a large neuroblastoma.

Journal Article (Journal Article;Review)

BACKGROUND: The English literature contains infrequent reports of neuroendocrine carcinoma during pregnancy. The chemotherapy for this type of malignancy can cause severe nausea and neutropenia. We used recently developed modalities to ameliorate these side effects. CASE: A 22-year-old woman, gravida 4, para 2-0-1-2, presented at 24 weeks' gestation with a complaint of massive lower-extremity edema. Computed tomography scan delineated a large retroperitoneal mass. Biopsy of a small neck mass revealed a poorly differentiated neuroblastoma. A multidisciplinary approach to therapy was undertaken. The patient received cisplatin and etoposide chemotherapy. Complications of the first course included severe neutropenia and nausea with vomiting. Filgrastim and ondansetron were used to treat these complications. She delivered an 1825-g healthy male by cesarean for fetal distress at 35 weeks. No anomalies were noted at birth. Neonatal hematologic indices were normal CONCLUSION: A multidisciplinary approach to rare malignancies is warranted in pregnancy. Filgrastim and ondansetron are effective agents in the treatment of chemotherapy-associated complications. Their use in pregnancy warrants further investigations.

Full Text

Duke Authors

Cited Authors

  • Arango, HA; Kalter, CS; Decesare, SL; Fiorica, JV; Lyman, GH; Spellacy, WN

Published Date

  • October 1994

Published In

Volume / Issue

  • 84 / 4 Pt 2

Start / End Page

  • 665 - 668

PubMed ID

  • 9205441

International Standard Serial Number (ISSN)

  • 0029-7844


  • eng

Conference Location

  • United States