Advertisement

Anesthesia for the Pregnant Patient with Intrathoracic Tumor

  • Bülent Serhan Yurtlu
  • Derya Arslan Yurtlu
Chapter

Abstract

Cancer in pregnancy is a rare occasion affecting less than 0.1% of all pregnancies. Either primary or secondary metastatic thoracic tumors during pregnancy account even a small portion of them. However, any lung tumor of a term pregnant has devastating potential influence during the anesthesia for childbirth. Due to extreme scarcity of these cases, there are no well-established anesthesia methods to overcome the problems encountered in this particular patient population. Data and information in this field are derived mainly from occasional case reports and mini reviews. The aim of this chapter is to give a structured information and to discuss the possible challenges that the anesthesiologist may come across.

Keywords

Lung tumor Anesthesia Pregnancy Labor Cesarean 

Notes

Conflict of Interest

None

Funding 

None

References

  1. 1.
    Howdeshell KL, Shelby MD. Epidemiology of cancer during pregnancy. In: Azim Jr HA, editor. Managing cancer during pregnancy. Basel: Springer; 2016. p. 3–16.CrossRefGoogle Scholar
  2. 2.
    Boussios S, Han SN, Fruscio R, Halaska MJ, Ottevanger PB, Peccatori FA, et al. Lung cancer in pregnancy: report of nine cases from an international collaborative study. Lung Cancer. 2013;82:499–59.CrossRefGoogle Scholar
  3. 3.
    Pavlidis N, Zarkavelis G. Managing thoracic tumours during pregnancy. In: Azim Jr HA, editor. Managing cancer during pregnancy. Basel: Springer; 2016. p. 185–91.CrossRefGoogle Scholar
  4. 4.
    Pavlidis NA. Coexistence of pregnancy and malignancy. Oncologist. 2002;7:279–879.CrossRefGoogle Scholar
  5. 5.
    Sarıman N, Levent E, Yener NA, Orki A, Saygı A. Lung cancer and pregnancy. Lung Cancer. 2013;79:321–3.CrossRefGoogle Scholar
  6. 6.
    Dieter RA Jr, Kuzycz GB, Dieter RA 3rd. Malignant and benign thoracic tumors during pregnancy. Int Surg. 2006;91:S103–6.PubMedGoogle Scholar
  7. 7.
    Azim HA Jr, Peccatori FA, Pavlidis N. Lung cancer in the pregnant woman: to treat or not to treat, that is the question. Lung Cancer. 2010;67:251–6.CrossRefGoogle Scholar
  8. 8.
    Whang B. Thoracic surgery in the pregnant patient. Thorac Surg Clin. 2018;28:1–7.CrossRefGoogle Scholar
  9. 9.
    Kim JW, Kim JS, Cho JY, Lee DH. Successful video-assisted thoracoscopic lobectomy in a pregnant woman with lung cancer. Lung Cancer. 2014;85:331–4.CrossRefGoogle Scholar
  10. 10.
    Kesrouani A, Dabar G, Rahal S, Ghorra C. Treatment of tracheal mucoepidermoid carcinoma by argon plasma coagulation during pregnancy. Int Surg. 2015;100:927–9.CrossRefGoogle Scholar
  11. 11.
    Alaily AB, Carrol KB. Pulmonary ventilation in pregnancy. Br J Obstet Gynaecol. 1978;85:518–4.CrossRefGoogle Scholar
  12. 12.
    Yurtlu S, Hakimoğlu S, Hancı V, Ayoğlu H, Erdoğan G, Özkoçak I. Epidural anesthesia for a parturient with superior vena cava syndrome. Turk J Anesth Reanim. 2012;40:52–7.  https://doi.org/10.5222/jtaıcs.2012.052.CrossRefGoogle Scholar
  13. 13.
    Reddy YN, Sundaram V, Stamler JS. An unusual case of peripartum pulmonary oedema. BMJ Case Rep. 2013;2013:bcr2013200150.  https://doi.org/10.1136/bcr-2013-200150.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Tyagi A, Sharma CS, Kumar S, Sharma DK, Jain AK, Sethi AK. Epidural volume extension: a review. Anaesth Intensive Care. 2012;40:604–3.PubMedGoogle Scholar
  15. 15.
    Lee CY, Izaham A, Zainuddin K. Anaesthetic management of a parturient with a mediastinal mass for caesarean delivery. Int J Obstet Anesth. 2013;22:356–8.  https://doi.org/10.1016/j.ijoa.2013.03.017.CrossRefPubMedGoogle Scholar
  16. 16.
    Chiang JC, Irwin MG, Hussain A, Tang YK, Hiong YT. Anaesthesia for emergency caesarean section in a patient with large anterior mediastinal tumour presenting as intrathoracic airway compression and superior vena cava obstruction. Case Rep Med. 2010;2010:708481.  https://doi.org/10.1155/2010/708481.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Chan YK, Ng KP, Chiu CL, Rajan G, Tan KC, Lim YC. Anesthetic management of a parturient with superior vena cava obstruction for cesarean section. Anesthesiology. 2001;94:167–9.CrossRefGoogle Scholar
  18. 18.
    Buvanendran A, Mohajer P, Pombar X, Tuman KJ. Perioperative management with epidural anesthesia for a parturient with superior vena caval obstruction. Anesth Analg. 2004;98:1160–3.CrossRefGoogle Scholar
  19. 19.
    Shastri U, Slinger P, Nguyen E, Carvalho JC, Balki M. Pulmonary edema during cesarean delivery in a patient with a mediastinal mass. Can J Anaesth. 2011;58:285–9.  https://doi.org/10.1007/s12630-010-9431-0.CrossRefPubMedGoogle Scholar
  20. 20.
    Erdös G, Tzanova I. Perioperative anaesthetic management of mediastinal mass in adults. Eur J Anaesthesiol. 2009;26:627–32.  https://doi.org/10.1097/EJA.0b013e328324b7f8.CrossRefPubMedGoogle Scholar
  21. 21.
    Roze des Ordons AL, Lee J, Bader E, Scheelar L, Achen B, Taam J, et al. Cesarean delivery in a parturient with an anterior mediastinal mass. Can J Anaesth. 2013;60:89–90.  https://doi.org/10.1007/s12630-012-9815-4.CrossRefPubMedGoogle Scholar
  22. 22.
    Bevinaguddaiah Y, Shivanna S, Pujari VS, Chikkapillappa MA. Anesthesia for cesarean delivery in a patient with large anterior mediastinal tumor presenting as intrathoracic airway compression. Saudi J Anaesth. 2014;8:556–8.  https://doi.org/10.4103/1658-354X.140901.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Slinger P, Karsli C. Management of the patient with a large anterior mediastinal mass: recurring myths. Curr Opin Anaesthesiol. 2007;20:1–3.CrossRefGoogle Scholar
  24. 24.
    Innamaa A, Deering P, Powell MC. Advanced lung cancer presenting with a generalized seizure in pregnancy. Acta Obstet Gynecol Scand. 2006;85:1148–9.CrossRefGoogle Scholar
  25. 25.
    Wang Y, Cui J, Yan X, Jin R, Hong X. Alveolar soft part sarcoma with multiple brain and lung metastases in pregnancy: a case report and literature review. Medicine (Baltimore). 2017;96:e8790.  https://doi.org/10.1097/MD.0000000000008790.CrossRefGoogle Scholar
  26. 26.
    Burlacu CL, Fitzpatrick C, Carey M. Anaesthesia for caesarean section in a woman with lung cancer: case report and review. Int J Obstet Anesth. 2007;16:50–62.CrossRefGoogle Scholar
  27. 27.
    Chhajed PN, Kate A, Chaudhari P, Tulasigiri C, Shetty S, Kesarwani R, et al. Massive hemoptysis during pregnancy. J Assoc Physicians India. 2011;59:660–2.PubMedGoogle Scholar
  28. 28.
    Ceauşu M, Hostiuc S, Sajin M, Roman G, Nicodin O, Dermengiu D. Gestational lung adenocarcinoma: case report. Int J Surg Pathol. 2014;22:663–6.  https://doi.org/10.1177/1066896914531816.CrossRefPubMedGoogle Scholar
  29. 29.
    Zambelli A, Prada GA, Fregoni V, Ponchio L, Sagrada P, Pavesi L. Erlotinib administration for advanced non-small cell lung cancer during the first 2 months of unrecognized pregnancy. Lung Cancer. 2008;60:455–7.CrossRefGoogle Scholar
  30. 30.
    Kim JH, Kim HS, Sung CW, Kim KJ, Kim CH, Lee KY. Docetaxel, gemcitabine, and cisplatin administered for non-small cell lung cancer during the first and second trimester of an unrecognized pregnancy. Lung Cancer. 2008;59:270–3.CrossRefGoogle Scholar
  31. 31.
    Kanellakos GW. Perioperative management of the pregnant patient with an anterior mediastinal mass. Anesthesiol Clin. 2012;30:749–8.  https://doi.org/10.1016/j.anclin.2012.07.010.CrossRefPubMedGoogle Scholar
  32. 32.
    Kashif S, Saleem J. Anaesthetic management of caesarean section in a patient with large mediastinal mass. J Coll Physicians Surg Pak. 2015;25:143–5.PubMedGoogle Scholar
  33. 33.
    Kojima M, Yoshie K, Shimazaki A, Ohtsuka N, Otake H, Koide K, et al. Anesthetic management of cesarean section in a pregnant woman with advanced tongue cancer. Masui. 2016;65:632–5.PubMedGoogle Scholar
  34. 34.
    Said M, Migaw H, Hafsa C, Braham R, Golli M, Moussa A, et al. Imaging features of primary pulmonary liposarcoma. Australas Radiol. 2003;47:313–7.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Bülent Serhan Yurtlu
    • 1
  • Derya Arslan Yurtlu
    • 2
  1. 1.Dokuz Eylül University, School of Medicine, Anesthesia and Reanimation DepartmentİzmirTurkey
  2. 2.Katip Celebi University, Atatürk Education and Research Hospital, Anesthesia and Reanimation DepartmentİzmirTurkey

Personalised recommendations