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Neuroendocrine Carcinoma of the Vagina in Pregnancy

ElNaggar, Adam C. MD; Patil, Avinash S. MD; Singh, Krishna MD; Reed, Mark E. MD

doi: 10.1097/AOG.0b013e318236ffcd
Case Reports
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BACKGROUND: Neuroendocrine carcinoma of the vagina is extremely rare. Treatment options in pregnancy are complex owing to the aggressive tumor type and poor prognosis.

CASE: We report the case of a gravid woman diagnosed with stage IVB neuroendocrine carcinoma of the vagina at 16 weeks of gestation. Disease responded to chemotherapy, and pregnancy was continued until onset of preterm labor at 28 5/7 weeks of gestation, with subsequent delivery of a viable fetus. Despite aggressive treatment with chemoradiation postpartum, the patient died of progressive disease 11 months after initial diagnosis.

CONCLUSION: A multidisciplinary team should review treatment options and potential complications with the patient. Because of the tendency toward early tumor dissemination, the optimal treatment for neuroendocrine carcinoma in pregnancy involves systemic chemotherapy.

Neuroendocrine carcinoma of the vagina is a rare, aggressive cancer with a poor prognosis and is best treated with immediate systemic therapy in pregnancy.

From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, and the Division of Gynecologic Oncology, University of Tennessee-West Clinic, Memphis, Tennessee; and the Divisions of Maternal-Fetal Medicine, Duke University Medical Center, Durham, North Carolina, and Cedars-Sinai Medical Center, Los Angeles, California.

Corresponding author: Adam C. ElNaggar, University of Tennessee, Department of Obstetrics and Gynecology, Suite E102, 853 Jefferson Ave, Memphis, TN; e-mail: aelnagga@uthsc.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2012 The American College of Obstetricians and Gynecologists