Colorectal cancer during pregnancy in a Sudanese female

Abstract

We report a new case of uncommon but not rare condition of colorectal cancer during pregnancy in 33 years old Sudanese female at her 16th weeks of gestation presented with bloody diarrhea and intermittent left side abdominal pain. Initially she was diagnosed as a case of dysentery which was treated by antibiotics. Condition was diagnosed by colonoscopy and histopathology as colonic cancer, located in the sigmoid colon 50 cm from anal verge. A review of literature found that 276 cases of colon cancer associated with pregnancy have been reported. Pregnancy affects the clinical presentation, evaluation, therapy, and prognosis of colon cancer. Patients usually present with misdiagnosed symptoms. Diagnostic delays often lead to the tragic demise of a young woman from a potentially curable disease and of an otherwise viable fetus. This delay in diagnosis is a major contributing factor to the poor prognosis associated with this disease. Synchronous colon cancer during pregnancy presents a diagnostic and therapeutic challenge for clinicians because there are no generally accepted guidelines regarding diagnosis or treatment. This article reviews this uncommon condition with a focus on the features of colon cancer in
pregnancy to facilitate earlier diagnosis, to modify investigations, to optimize the therapy, and to improve the maternal and fetal outcomes.

Keywords: Colorectal cancer; Pregnancy; CEA, FOLFOX