Gynecologic malignancies in pregnancy

BECAUSE OF their direct anatomic and functional relationship with the developing fetus, gynecologic cancers present unique problems during pregnancy. Cancers of the cervix and ovary are seen with some regularity, while tumors of the vulva, vagina, and endometrium are exceedingly rare. With some modification, the diagnosis and evaluation of gynecologic cancers during pregnancy are similar to that in nonpregnant women. Attempts should be made to limit fetal exposure to diagnostic radiation, and decisions regarding tissue biopsy should be carefully considered, because the pelvis is much more vascular during pregnancy. Treatment of malignancy should be tailored to the extent of disease, gestational age of the fetus, and maternal desires. Most patients with early-stage disease can anticipate an outcome similar to their nonpregnant counterparts.