Evaluation and management of the pregnant patient with suspected primary musculoskeletal tumor or metastatic carcinoma to bone

Varun Puvanesarajah, Andrea M. Spiker, Brett A. Shannon, Maureen Grundy, Adam Levin, Carol D Morris

Research output: Contribution to journalReview article

Abstract

Primary musculoskeletal cancer and metastatic disease to bone in pregnant patients presents major treatment challenges. Although uncommon, musculoskeletal malignancies in pregnant women have been reported. When diagnosing and treating these patients, the mother's health must be managed appropriately while ensuring that fetal development is not deleteriously affected. Extensive radiographic imaging and more advanced techniques are often necessary to fully characterize the extent of disease. When possible, magnetic resonance imaging should be used instead of computed tomography to limit exposure of the conceptus to radiation. If treatment is needed, therapeutic radiation, chemotherapy, and surgery should be considered. Surgical resection is the foundation of treatment of early-stage primary bone tumors and soft-tissue sarcomas during pregnancy. With surgery, anesthesia and thromboprophylaxis are important considerations. If chemotherapy is required, administration should be avoided in the first trimester to limit harm to the fetus. Therapeutic radiation should similarly be avoided during the first trimester and often can be postponed until after delivery.

Original languageEnglish (US)
Pages (from-to)212-222
Number of pages11
JournalSurgical Oncology
Volume25
Issue number3
DOIs
StatePublished - Sep 1 2016

Fingerprint

Carcinoma
Bone and Bones
First Pregnancy Trimester
Radiation
Neoplasms
Therapeutics
Drug Therapy
Bone Diseases
Fetal Development
Sarcoma
Pregnant Women
Fetus
Anesthesia
Tomography
Mothers
Magnetic Resonance Imaging
Pregnancy
Health

Keywords

  • Cancer
  • Chemotherapy
  • Musculoskeletal malignancy
  • Orthopaedic surgery
  • Pregnancy
  • Radiation

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Evaluation and management of the pregnant patient with suspected primary musculoskeletal tumor or metastatic carcinoma to bone. / Puvanesarajah, Varun; Spiker, Andrea M.; Shannon, Brett A.; Grundy, Maureen; Levin, Adam; Morris, Carol D.

In: Surgical Oncology, Vol. 25, No. 3, 01.09.2016, p. 212-222.

Research output: Contribution to journalReview article

Puvanesarajah, Varun ; Spiker, Andrea M. ; Shannon, Brett A. ; Grundy, Maureen ; Levin, Adam ; Morris, Carol D. / Evaluation and management of the pregnant patient with suspected primary musculoskeletal tumor or metastatic carcinoma to bone. In: Surgical Oncology. 2016 ; Vol. 25, No. 3. pp. 212-222.
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