Northwestern MedicineLifesaving Case: Emergency C-Section and Cancer Treatment Amid Melanoma Diagnosis

This video case presents a rare intersection of pregnancy-associated melanoma with severe cardiopulmonary compromise, demonstrating the critical importance of coordinated multidisciplinary care in managing complex maternal conditions. The case highlights successful implementation of pre-surgical immunotherapy in the context of pregnancy-associated melanoma.

Key Clinical Considerations:

• Diagnostic Complexity: The 12cm thoracic mass presented diagnostic challenges due to extensive necrotic tissue, complicated by full-term pregnancy causing respiratory restriction, requiring urgent intervention.
• Multidisciplinary Coordination: Successful management required synchronized efforts across maternal-fetal medicine, thoracic surgery, and medical oncology teams operating across multiple ORs.
• Treatment Innovation: Patient received 3 cycles of pre-surgical immunotherapy as part of a clinical trial protocol, achieving complete pathologic response before surgical intervention.
• Pregnancy Considerations: Emergency C-section was prioritized due to high risk of cardiorespiratory collapse from combined effects of tumor mass and term pregnancy.
• Surveillance Protocol: Post-treatment plan includes continued immunotherapy for one year with regular imaging surveillance to monitor for recurrence.

Melanoma is one of the most commonly diagnosed cancers in pregnancy, and data suggest that 35% of women diagnosed with melanoma are of childbearing age. (J La State Med Soc.)

Maternal-Fetal Medicine Summaries