Case Report

Gastric cancer in differential diagnosis of hyperemesis gravidarum: Case report

  • Erdogan Aslan
  • Erhan Simsek
  • Esra Kiliçdag
  • Filiz Bolat
  • Tarik Zafer Nursal
  • Bülent Haydardedeoglu

Turk J Obstet Gynecol 2008;5(1):36-39

Gastric cancer in pregnancy is rare and, portends a grave prognosis probably due to its relatively late diagnosis at an advanced state. Because many nonspecific gastrointestinal symptoms are attributed mainly to nausea and vomiting of pregnancy which is a broad term and hesitation may exist subjecting pregnant women to extensive diagnostic procedures, delay in diagnosis usually ensues. A 30-year-old multigravida in her 22nd week of gestation was referred to our institution because of nausea, vomiting, heartburn, and epigastric pain resistant to therapy with antiacid, sucralfate, H2 receptor blockers, antibiotics and, antispasmodics which were given on multipl occations throughout her pregnancy. In abdominal ultrasonography a mass lesion adjacent to liver was detected. Gastric carcinoma was diagnosed by biopsy taken by endoscopy. The patient and family decided not to terminate the pregnancy. At 24th week of gestation subtotal gastrectomy, gastrojejunostomy, Witzel jejunostomy, and lymphadenectomy procedures were performed. Histopathology confirmed signet cell type gastric carcinoma. After corticosteroid therapy a 1450 gr weighing male baby was delivered by c/s at 29 week and 3 days of gestation with the parents’ insistence in order to institute chemotherapy as soon as possible. The baby was discharged from neonatal intensive care unit after 5 days. The patient is alive and disease free at 36 months postoperatively.

Keywords: Hyperemesis gravidarum, gastric cancer, nausea and vomiting of pregnancy, endoscopy\r\n