通讯作者: 郑明康, zmk120@sina.com

DOI：10.12201/bmr.202610.00002

Clinical Analysis and Literature Review of a Case of Colorectal Cancer with Ovarian, Hepatic, and Renal Metastases During Pregnancy

• 摘要：妊娠期结肠癌发病率低，临床罕见。目前，在发病机制、诊断方式、治疗方案及终止妊娠时机的选择上，国内外尚未形成统一共识。本文报告1例妊娠期结肠癌伴卵巢及肝肺转移患者的诊治过程。患者妊娠中后期因反复腹痛、腹部包块多次入院诊治，并辗转多家综合医院就诊，先后完善粪便潜血、肿瘤标志物、粪便基因检测、腹部超声、腹部磁共振成像（magnetic resonance imaging，MRI）等检查，因检查受限及风险规避，未能明确诊断。病情进展至结肠癌伴卵巢转移，孕35周时终止妊娠，行剖宫产术及右侧附件切除术，术中发现升结肠肿瘤病灶。转至综合医院进一步完善正电子发射断层显像/X线计算机体层成像（positron emission tomography/computedtomography，PET/CT）及结肠镜检查，明确诊断为升结肠癌并肝肺转移，行腹腔镜右半结肠切除术及术后8个周期化疗。总结诊疗过程并结合相关文献复习，以期为妊娠期结肠癌的诊断和治疗提供经验。

  关键词： 妊娠期；结肠肿瘤；肿瘤转移；终止妊娠；多学科会诊; ; ; ; 

   

  Abstract: Colorectal cancer during pregnancy is relatively rare clinically, and there remains no consensus regarding its pathogenesis, diagnostic approaches, treatment strategies, or optimal timing for pregnancy termination. This article reports the management of a case of pregnant women with colorectal cancer accompanied by ovarian and hepatic/renal metastases. During the mid-to-late stages of pregnancy, the patient was hospitalized multiple times due to recurrent abdominal pain and an abdominal mass, seeking care at various general hospitals. Comprehensive examinations—including fecal occult blood tests, tumor markers, fecal genetic testing, abdominal ultrasound, and MRI—were performed without definitive diagnosis. The condition progressed to colorectal cancer with ovarian metastases; at 35 weeks of gestation, the pregnancy was terminated via cesarean section with right adnexectomy, during which an ascending colon tumor lesion was identified. Subsequent evaluation at a general hospital using PET/CT and colonoscopy confirmed a diagnosis of ascending colon carcinoma with hepatic and renal metastases, leading to right hemicolectomy followed by eight cycles of postoperative chemotherapy. This case report, combined with literature review, aims to provide insights into the diagnosis and management of colorectal cancer during pregnancy.

  Key words: Pregnancy; Colon tumor; Tumor metastasis; Termination of pregnancy; Multidisciplinary consultation

  提交时间：2026-10-03

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-07-07	10.12201/bmr.202610.00002V1	下载

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