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  • #658 A clinical case of non-Hodgkin’S B-Cell lymphoma of rare localization (ovaries) during pregnancy in a patient with a CFTR gene mutation causing cystic fibrosis

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Poster/ePoster Sessions
04. Fertility/Pregnancy
#658 A clinical case of non-Hodgkin’S B-Cell lymphoma of rare localization (ovaries) during pregnancy in a patient with a CFTR gene mutation causing cystic fibrosis
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  1. Elena Dikareva1,
  2. Galina Salogub1,
  3. Oksana Zhamborova1,
  4. Aminat Dzharbaeva1,
  5. Eduard Komlichenko1,
  6. Natalia Osipova1,
  7. Daria Ulrikh2,
  8. Tatyana Pervunina1,
  9. Yulia Alexeeva1,
  10. Ada Urmancheeva3,2,
  11. Igor Govorov1 and
  12. Elena Ulrikh1,3,2
  1. 1Almazov National Medical Research Centre, Saint Petersburg, Russia
  2. 2Petrov National Medical Research Center of Oncology, Saint Petersburg, Russia
  3. 3Mechnikov North-Western State Medical University, Saint Petersburg, Russia

Abstract

Introduction/Background Primary ovarian site manifestation of lymphomas are sporadic neoplasms, accounting 0,2–1,1% of all cases of extranodal non-Hodgkin’s B-cell lymphoma predominantly with unfavorable prognosis. The accompaing of these diseases with pregnancy is an extremely rare condition that causes difficulties in diagnosis and treatment

Methodology Pregnant thirty-nine-year-old patient after In vitro fertilization with Pre-implantation Genetic Diagnostics due to mutation in the CFTR gene which was diagnosed after cystic fibrosis (with severe lung/digestive system disorders) in the first child. At gestational age (GA) 24 weeks ORADS-4 ovarian neoplasm was detected. Non-contrast MRI discovered a solid lesion measuring 14,5x8,8x10,5cm in the left ovary with signs of true diffusion restriction and ascites. Due to pain, peritoneal symptoms an emergency operation was performed: laparotomy, left adnexectomy, omentectomy (due to preoperative rupture of the tumor with hemorrhage and adhesions to the omentum). Morphologically high-grade B-cell lymphoma, not otherwise specified (HGBL-NOS) with Ki67–97% was detected (figure 1). After whole body MRI scanning tumor changes of the paraaortic lymph nodes were diagnosed. Taking into account strong wish of patient to maintain pregnancy, the high-grade lymphoma, the risk of worsening the prognosis the DA-EPOCH-R chemotherapy was initiated.

Abstract #658 Figure 1
Abstract #658 Figure 1

Malignant neoplasm of the left ovary (lymphoma) during pregnancy

Results After three cycles of DA-EPOCH-R chemotherapy (with reduction of tumor foci up to 98% without significant toxicity) the cesarean section was performed at GA 37 1/7. Newborn: boy, weight: 3080 g, Apgar 8/9, healthy. The patient continuing treatment in the hematology department with ongoing tumor reduction.

Conclusion The combination of non-Hodgkin’s B-cell lymphoma of rare localization (ovaries) during pregnancy is extremely uncommon morbidity with possibility of prolonging pregnancy along with treatment in a specialized, multidisciplinary medical center. This makes it possible to conduct a full-fledged examination, prescribe adequate and timely treatment while minimizing risks to the fetus, prolong pregnancy to full term, and create conditions for the birth of a healthy child.

Disclosures Nothing to disclose

https://doi.org/10.1136/ijgc-2023-ESGO.436

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