Disseminated gastrointestinal stromal tumor in pregnancy. A case report

Background. Gastrointestinal stromal tumor (GiST) is a rare neoplasm with an incidence of only 10-20 cases per million population. All gastrointestinal neoplasms may have malignant potential and most of them are sporadic tumors. GiST occurring during pregnancy is extremely rare, therefore, surgeons face challenging ethical, surgical and oncological issues. Case. We describe a clinical cause of GiST found at the 16-17-th week of pregnancy in a 31-year-old woman. The patient was under the supervision of obstetricians-gynecologists, radiologists and oncologists, and a weekly ultrasound examination was performed. Caesarean delivery was performed at the 26th week of pregnancy due to disease progression and in order to start anticancer therapy as soon as possible. Conclusion. We described the first reported case of a successful treatment in a 31-year-old pregnant patient with GiST of the small intestine complicated by peritoneal carcinomatosis and ascites. We compared our case with other reported cases of GiST during pregnancy and discussed the problems faced by both patients and surgeons. There are no recommendations on the optimal timing of tumor resection during pregnancy, and therefore key decisions must be made in a multidisciplinary team (MDT), taking into account the wishes of the patient. Our clinical case demonstrates the feasibility of changing the approaches to the management and treatment of patients with intraperitoneal dissemination, as well as emphasizes the importance of interdisciplinary team including oncologists, obstetricians, gynecologists, neonatologists and other specialists.