To the Editor: A 26-year-old woman had had abdominal pain sincethe beginning of her pregnancy. Endoscopy of the esophagus,stomach, and duodenum and abdominal ultrasonography showed onlygastroesophageal reflux. Two months later, physical examinationrevealed a palpable left supraclavicular lymph node and hepatomegaly.Repeated abdominal ultrasonography showed multiple hepatic metastases.
The patient underwent an exploratory laparotomy during the 34thweek of gestation, during which her baby was delivered by cesareansection; the infant was subsequently admitted to the neonatologyunit. During the surgery, no primary tumor was identified. Hepaticbiopsy showed a metastatic, well-differentiated mucinous adenocarcinoma.Mammography, breast ultrasonography, . . . [Full Text of this Article]
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