Management of undifferentiated embryonal sarcoma of the liver in pregnancy

BACKGROUND: Undifferentiated embryonal sarcoma of the liver is a rare mesenchymal neoplasm with a poor prognosis. Most cases occur in children, with few cases reported in adults. Our patient was a woman whose pregnancy was complicated by the recurrence of metastatic undifferentiated embryonal sarcoma of the liver. CASE: In the medical literature only two other women have been described with metastatic undifferentiated embryonal sarcoma of the liver in pregnancy. This is the first reported case of undifferentiated embryonal sarcoma of the liver recurring in and requiring treatment during pregnancy. Radio frequency ablation was used to try to control sites of hepatic disease recurrence during the pregnancy. The patient gave birth to a healthy son before requiring further palliative chemotherapy. CONCLUSION: This case highlights the fact that cancer not infrequently complicates pregnancy and can require treatment, in this case with radio frequency ablation. The case also illustrates a range of complex issues that arise when a patient with cancer has a pregnancy: the doctor's recommendations, the patient's right to choose, the well-being of the infant, and the unpredictable behavior of cancer.