Colorectal cancer complicating pregnancy.
Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Sacramento, USA.
Colorectal carcinoma complicating pregnancy is rare but associated with a high maternal mortality rate. Stage for stage the survival data are the same for pregnant patients and nonpregnant controls, however diagnosis is often delayed due to pregnancy-associated gastrointestinal symptoms masking cancer symptoms. A high degree of suspicion, especially in high-risk patients, is the key to early detection and improved prognosis. Digital rectal exams, occult fecal blood tests, and flexible sigmoidoscopy or colonoscopy are performed as indicated. Treatment primarily consists of en-bloc resection of the malignancy and regional lymph nodes; timing of colorectal surgery and delivery are based upon clinical presentation, fetal age, and maternal desires.