Advanced rectal cancer with multiorgan metastasis detected after single fetal death in twin pregnancy: a case report.

Authors

Suzuka Inoue, Yuki Ito, Akihiro Hasegawa, Haruna Okubo, Tokumasa Suemitsu, Hitoshi Matsui, Ken Takahashi, Taizan Kamide, Kentaro Harada, Masayuki Saruta, Takuhiro Kawahara, Nei Fukasawa, Masayuki Shimoda, Osamu Samura, Aikou Okamoto

Published in

AME case reports. Volume 10. Pages 108. Epub Apr 26, 2026.

Abstract

Detection of colorectal cancer (CRC) during pregnancy is rare; moreover, its diagnosis is often delayed because its symptoms overlap with the physiological changes that occur during gestation. Reports of pregnancies complicated by advanced malignancy in which non-reassuring fetal status (NRFS) occurred are rare.
Herein, we report a case involving a twin pregnancy in which single fetal death served as a crucial clue for the detection of advanced CRC with multiorgan metastasis. A 36-year-old pregnant woman was admitted at 26 weeks and 3 days with suspected preterm contractions, a NRFS with elevation of inflammatory markers or activated coagulation. Despite thorough monitoring, intrauterine fetal death (IUFD) was observed for Fetus I at 28 weeks and 0 days. Imaging studies performed to investigate the fetal death and maternal inflammation revealed multiple masses in the liver. At 28 weeks and 2 days of gestation, findings suggestive of NRFS were observed for Fetus II. Emergency cesarean section was performed on the same day. Histopathology of both placentas demonstrated extensive infarctions. Following delivery, a thorough examination of the maternal liver led to a diagnosis of advanced CRC with multiple metastases. The patient underwent chemotherapy but succumbed to progressive disease 13 months later. Placental dysfunction due to maternal malignancy-associated hypercoagulability was considered the likely mechanism of IUFD.
In cases of advanced cancer during pregnancy, attention must also be paid to fetal-placental function. In pregnant women, when IUFD occurs accompanied by unexplained maternal inflammatory response elevation and coagulation activation, thorough investigation for malignant tumors is necessary.

PMID:
42299384
Bibliographic data and abstract were imported from PubMed on 16 Jun 2026.

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