A successful case of neoadjuvant chemotherapy and radical hysterectomy during pregnancy for advanced uterine cervical cancer accompanied by neonatal erythroderma

J Obstet Gynaecol Res. 2018 Oct;44(10):2003-2007. doi: 10.1111/jog.13746. Epub 2018 Jul 25.

Abstract

Recent reports showed that neoadjuvant chemotherapy (NAC) has been successfully applied to treat advanced uterine cervical cancers during pregnancy. However, its side effects on the fetus remain unclear. Here, we report a 33-year-old primipara who underwent four courses of NAC therapy, paclitaxel and cisplatin, from 17 to 27 weeks of gestation due to uterine cervical cancer stage IB2. At 31 weeks of gestation, cesarean section and radical hysterectomy were performed, and a female baby weighing 1446 g was born. Although pre- and postnatal courses were uneventful, neonatal erythroderma over the entire body was observed just after delivery. The pathological diagnosis was ichthyosiform erythroderma, which was later demonstrated to be keratitis-ichthyosis-deafness syndrome, by exome sequencing analysis. Although her skin disorder was consistent with keratitis-ichthyosis-deafness syndrome, the skin condition gradually improved after delivery. These findings suggest that NAC therapy during pregnancy might cause or exacerbate systemic skin lesions in the fetus/neonate.

Keywords: cervical cancer; neoadjuvant chemotherapy; neonatal erythroderma; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects*
  • Cesarean Section
  • Chemotherapy, Adjuvant / adverse effects
  • Female
  • Humans
  • Hysterectomy
  • Ichthyosiform Erythroderma, Congenital / chemically induced*
  • Infant, Newborn
  • Keratitis / chemically induced*
  • Pregnancy
  • Pregnancy Complications, Neoplastic* / drug therapy
  • Pregnancy Complications, Neoplastic* / surgery
  • Uterine Cervical Neoplasms* / drug therapy
  • Uterine Cervical Neoplasms* / surgery

Substances

  • Antineoplastic Agents

Supplementary concepts

  • Keratitis-Ichthyosis-Deafness Syndrome