Cancer during pregnancy is a rare but complex clinical scenario that affects approximately 0.1% of pregnant individuals and is associated with increased maternal morbidity. With the trend of delayed childbearing, the incidence of pregnancy-associated cancers is expected to rise. Neuroendocrine neoplasms (NENs), although rare in pregnancy, present unique diagnostic and therapeutic challenges due to their hormonal activity, histological diversity, and limited data on management in the gestational context. Objectives: This manuscript reviews the current evidence on the diagnosis, staging, and management of NENs during pregnancy, focusing on maternal–fetal safety, therapeutic limitations, and multidisciplinary care strategies. Methods: A comprehensive narrative review was conducted using relevant case reports, retrospective studies, clinical guidelines, and expert consensus documents addressing cancer in pregnancy and NEN-specific management. Results: Pregnancy complicates the evaluation and treatment of NENs due to overlapping symptoms, contraindications to standard imaging and systemic therapies, and unreliable biomarkers such as chromogranin A and 5-HIAA. Most systemic therapies for NENs, including somatostatin analogs, tyrosine kinase inhibitors, and peptide receptor radionuclide therapy, are contraindicated or lack safety data in pregnancy. Surgical interventions and supportive care require careful planning. Decisions regarding pregnancy continuation or termination must be individualized and supported by a multidisciplinary team. Conclusions: The management of NENs during pregnancy demands a highly individualized approach, coordinated among oncology, maternal–fetal medicine, and supportive care teams. Given the paucity of robust data, future research is essential to establish evidence-based guidelines and improve outcomes for both mother and fetus.

Background: Metastasis of colorectal cancer to the central nervous system (CNS) is relatively rare but leads to shorter survival for these patients, even with improvements in palliative treatments. Objectives: The primary objective of this study was to assess the overall survival of patients with brain metastasis from colorectal cancer treated at the A.C. Camargo Cancer Center. The secondary objectives were to identify clinical and epidemiological factors, correlate clinicopathological factors with overall survival, and describe prognostic factors associated with CNS metastasis. Methods: We retrospectively evaluated patients with metastatic colorectal cancer and CNS involvement treated from January 2002 to August 2020 at a single cancer center. Results: We identified 46 patients with a median age of 63.9 years; 50% were male, and 80% had a good performance status. The predominant primary site was the left colon (71.7%). Sixty percent were stage IV, 71.7% had previously presented with lung metastasis, and 76.7% had a high volume of lung disease. RAS mutations were detected in 56.5% of the pts. Progression to the CNS occurred after a median of three treatment lines, with a median time of 49.5 months between diagnosis and progression to the CNS. Sixty percent had supratentorial lesions, and 55.6% had only one lesion. After a median follow-up time of 27.2 months, the overall survival was 6.4 months. Surgery and radiation were associated with improved overall survival (HR 0.24, 95% CI 0.09-0.67; p = 0.006; and HR 0.20, 95% CI 0.08-0.5; p = 0.001, respectively). Conclusion: Our study found that most patients with CNS metastasis experienced progression after three lines of palliative treatment, had prior high-volume lung metastasis, and presented with left-sided tumors. Surgery and radiation may improve overall survival.