Abstract
Background
Metastatic retroperitoneal adenocarcinoma presenting as obstructed labor is extremely rare.
Case
An unbooked 35-year-old multipara came to our casualty in obstructed labor at 38 weeks of pregnancy. A palpable retroperitoneal mass was found behind the gravid uterus and cervix after delivery of a live baby during emergency cesarean section. Needle biopsy was taken from the mass and abdomen was closed due to nonavailability of frozen section facility at night. Post cesarean section CT scan confirmed the pelvic mass, which was subjected to open biopsy. A diagnosis of retroperitoneal adenocarcinoma with an unknown primary was made based on histopathology and a negative workup for the possible primary sites. Patient was treated successfully with chemotherapy and did not show recurrence for last 2 years of follow-up.
Conclusion
Surgeons should be aware of this extremely rare entity and it highlights the importance of proper antenatal care to pick up such pathology at an early stage by careful examination and ultrasound to minimize the morbidity and mortality. We also suggest frozen biopsy in a suspected pelvic mass during surgery and early cesarean section to avoid the complications of obstructed labor in such advanced stages of malignant tumor.
Similar content being viewed by others
References
Nagasaka K, Hojo S, Sakamoto K, Kakinoki S, Mori M, Takizawa K (2005) Primary undifferentiated carcinoma arising from the retroperitoneum: a case report. Int J Gynecol Cancer 15(6):1108–1111. doi:10.1111/j.1525-1438.2005.00267.x
Foruhan B (1979) Retroperitoneal sarcomas obstructing delivery—two cases reports. Brit J of Obstet Gynaecol 86:747–748
Levin S, Zuker N, Grishkan A, Ezra Y, Rizel S (1978) Advanced papillary adenocarcinoma of unknown origin as tumor previa during late pregnancy. Int J Gynaecol Obstet 25:337–340. doi:10.1016/0020-7292(87)90295-5
Petersen WF, Prevost EC, Edmunds FT, Hundley JM Jr, Morris FK (1955) Benign cystic teratomas of the ovary. Am J Obstet Gynecol 70:368–382
Moertel CG, Reitermeir RJ, Scutt AJ, Hahn RG (1972) Treatment of the patient with adenocarcinoma of unknown origin. Cancer 30(6):1469–1472. doi :10.1002/1097-0142(197212)30:6<1469::AID-CNCR2820300609>3.0.CO;2-T
Ditto A, Martinelli F, Carcangiu ML, Hanozet F, Solima E, Barisella M et al (2007) Incidental diagnosis of primary vaginal adenocarcinoma of intestinal type: a case report and review of the literature. Int J Gynecol Pathol 26(4):490–493
Mudhar HS, Smith JH, Tidy J (2001) Primary vaginal adenocarcinoma of intestinal type arising from an adenoma: case report and review of the literature. Int J Gynecol Pathol 20:204–209
Berger A, Rouzier R, Carnot F, Braunberger E, Cugnenc PH, Danel C (2001) Primary adenocarcinoma of the rectovaginal septum: a case report and literature review. Eur J Obstet Gynecol Reprod Biol 95(1):111–113
Bezjian AA (1984) Pelvic masses in pregnancy. Clin Obstet Gynecol 27(2):402–415
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ghosh, S.B., Tempe, A. Retroperitoneal adenocarcinoma of unknown origin presenting as a rare cause of obstructed labor. Arch Gynecol Obstet 279, 427–429 (2009). https://doi.org/10.1007/s00404-008-0742-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-008-0742-0