Increased abdominal girth in a 29-year-old breast cancer patient with extensive liver metastasis and presumed chemotherapy induced amenorrhea. A case report and review of the literature

Excerpt

A 27-year-old woman received treatment with neoadjuvant dose-dense doxorubicin, cyclophosphamide, and paclitaxel, modified radical mastectomy, and post-surgery radiation for stage III locally advanced estrogen and progesterone receptor negative and Her-2/neu overexpressing breast carcinoma in the spring of 2004. Her disease recurred in May of 2005, and was treated with trastuzumab, vinorelbine and zoledronic acid for extensive metastatic disease to the liver (Fig. 1), upper lung pleura, and bones; she also required radiation treatment to the C4-T5 area to palliate her symptoms. Her pain and performance status dramatically improved. However, 4 months into her chemotherapy, at the age of 29, she complained of abdominal bloating and increase in abdominal girth. The cause of her symptoms was suspected to be progressive disease in the liver. A restaging CAT scan revealed significant improvement in her hepatic metastases (Fig. 2), but surprisingly, an intrauterine live pregnancy was also documented and confirmed by fetal ultrasound with an estimated date of gestation of 21 weeks and 6 days (Fig. 3).

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