Successful Pregnancy in a 29-Year-Old G3P2 Shortly After Unilateral Pneumonectomy and Systemic Chemotherapy for Lung Cancer: A Case Report

Patient: Female, 29-year-old Final Diagnosis: Successful pregnancy shortly after unilateral pneumonectomy and systemic chemotherapy for lung cancer Symptoms: Hemoptysis Clinical Procedure: Unilateral pneumonectomy Specialty: Obstetrics and Gynecology OBJECTIVE: Rare disease BACKGROUND: The incidence of tumors during pregnancy, generally, is very uncommon. The incidence of lung cancer during pregnancy, specifically, is exceedingly rare. Several investigations have documented favorable maternal-fetal outcomes for later pregnancies after pneumonectomy due to non-cancer-related causes (mostly progressive pulmonary tuberculosis). However, very little is known about maternal-fetal outcomes for future conceptions after pneumonectomy due to cancer-related causes and subsequent chemotherapy cycles. This is an important knowledge gap in the literature that needs to be filled. CASE REPORT: A 29-year-old woman (non-smoker) had adenocarcinoma of the left lung, which was discovered during her pregnancy at 28 weeks of gestation. She underwent an urgent lower-segment transverse cesarean section at 30 weeks and subsequently underwent unilateral pneumonectomy and then completed her planned adjuvant chemotherapy. The patient was incidentally found to be pregnant at 11 weeks of gestation (roughly 5 months after the completion of her adjuvant chemotherapy cycles). Hence, the conception was estimated to have happened roughly 2 months after the completion of her chemotherapy cycles. A multidisciplinary team was formed and it was decided to keep her pregnancy as there was no clear medical reason to terminate it. The pregnancy was carried out to term gestation at 37+4 weeks with close monitoring, and she delivered a healthy baby via lower-segment transverse cesarean section. CONCLUSIONS: Successful pregnancy after unilateral pneumonectomy and adjuvant systematic chemotherapy is rarely reported. The maternal-fetal outcomes after unilateral pneumonectomy and systematic chemotherapy need expertise and a multidisciplinary approach to prevent complications.