Carcinomas of the colon and rectum are the third most frequent in women of all age groups in the United States (American Cancer Society, 2016). heir incidence in pregnancy is rising because of delayed childbearing (Rogers, 2016) . Even so, colorectal tumors are uncommon before age 40. Smith and colleagues (2003) reported an approximate incidence of 1 per 150,000 deliveries in the California Cancer Registry. he incidence approximated 1 per 35,000 births in a Danish Registry (Eibye, 2013). Most-80 percent-of colorectal carcinomas in pregnant women arise from the rectum. In one review, only 41 cases in pregnancy were colon cancers above the peritoneal reflection (Chan, 1999).
he most frequent symptoms of colorectal cancer are abdominal pain, distention, nausea, constipation, and rectal bleeding. If symptoms of colon disease persist, digital rectal examination, stool tests for occult blood, and lexible sigmoidoscopy or colonoscopy are done. Some malignancies of the gastrointestinal tract are discovered because of metastases to the ovary. Kruckenberg tumors are tumor-laden ovaries from another primary, often gastrointestinal, and have a bleak prognosis (GliSic, 2006; Kodama, 2016).
Treatment of colon cancer in pregnant women mirrors the same general guidelines as for nonpregnant women. Without evidence of metastatic disease, surgical resection is preferred, but most gravidas have advanced lesions (AI-Ibrahim, 2014). During the first half of pregnancy, hysterectomy is not necessary to perform colon or rectal resection, and thus, therapeutic abortion is not mandated. During later pregnancy, therapy may be delayed until fetal maturation, however, bowel hemorrhage, obstruction, or perforation may force surgical intervention (Minter, 2005).
Gastric cancer is rarely associated with pregnancy, and most reported cases are from Japan. Hirabayashi and coworkers (1987) reviewed outcomes in 60 pregnant women during a 70-year period from 1916 to 1985. Delayed diagnosis during pregnancy is common, and the prognosis is consistently poor (Lee, 2009). Esophageal cancer has similar symptoms, but it is rare (Sahin, 2015). It is axiomatic that persistent unexplained upper gastrointestinal symptoms should be evaluated by endoscopy.
Various other neoplasms have been reported in pregnancy and are usually the subject of case reports. Examples include carcinoid tumors, which are usually of gastrointestinal origin (Durkin, 1983). Both pancreatic and hepatocellular cancer are rare during pregnancy (Kakoza, 2009; Marinoni, 2006; Papoutsis, 2012; Perera, 2011). Another report described a massive intrahepatic cholangiocarcinoma masquerading as HELLP syndrome (Bladerston, 1998). Except for thyroid cancer, malignant tumors of the head and neck are rare (Cheng, 2015). Lung cancer is also uncommon (Boussios, 2013). Central nervous system neoplasms had a reported frequency of 1 in 10,000 to 28,000 births (Eibye, 2013; Smith, 2003). Bladder and urachal duct carcinoma are rarely coincident with pregnancy (McNally, 2013; Yeaton-Massey, 2013). Last, bone tumors have been described (Kathiresan, 2011).