Bone malignancies in pregnancy

Michael Lishner, Alla Osadchy

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Primary bone cancer is rarely associated with pregnancy [1,2]. The available information regarding its evaluation and management is very limited. A delay in diagnosis due to misinterpretation of tumor-related symptoms as those of normal pregnancy has been suggested [3]. Although magnetic resonance imaging is the diagnostic method of choice [4] and can be repeated many times in pregnancy [5], ultrasound, biopsy to stage the tumor, and clinical examination remain equally safe and important in arriving at the diagnosis. Tests applying X-rays or gamma-rays (isotope scans) should be avoided [6]. Independence of bone tumors from hormonal regulation was shown [3]. The association of bone neoplasm with pregnancy may be fortuitous [7]. Rare cases of recurrent bone tumors diagnosed during pregnancy might be due to increased medical surveillance [8]. Therapeutic considerations are complex, and a combined modality approach including surgery, radiation, and chemotherapy is often used and should be tailored to the individual patient. While surgical resections are generally regarded as safe during pregnancy, chemotherapy and radiation treatment are likely to be deferred until after delivery [6,9]. The decision-making analysis should include the type and site of the primary tumor, its growth rate and associated symptoms, the use of specific diagnostic tests, and appropriate treatment options [10]. Vaginal deliveries are possible [6,9]. In cases of bone malignancies involving the pelvis, cesarean section delivery might be considered to increase fetal safety [11]. Nevertheless, spontaneous vaginal deliveries after hemipelvectomy due to malignant tumors of the pelvis have been reported [12].

Original languageEnglish
Title of host publicationCancer in Pregnancy and Lactation
Subtitle of host publicationThe Motherisk Guide
PublisherCambridge University Press
Number of pages2
ISBN (Electronic)9780511794995
ISBN (Print)9781107006133
StatePublished - 1 Jan 2011


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