Rapidly enlarging renal tumor during pregnancy: diagnostic and management dilemma

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Kor Woi Tiang
Keng Lim Ng
Antonio Vega-Vega
Simon Wood

Keywords

renal cell carcinoma, pregnancy, chromophobe

Abstract

Urological tumors diagnosed during pregnancy are rare. However, the incidence seems to be increasing largely due to advancements in modern imaging techniques and improved antenatal care. The diagnosis and management of renal tumors during pregnancy poses a dilemma to clinicians. This case report highlights the challenges in managing a large chromophobe renal cell carcinoma in a young primigravida patient. Proper antenatal assessment, a multidisciplinary team approach and appropriate discussion with patient are important determinants to achieve the best clinical outcomes for both the mother and the baby.

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References

1. Smith LH, Danielsen B, Allen ME, Cress R. Cancer associated with obstetric delivery: results of linkage with the California cancer registry. Am J Obstet Gynecol. 2003;189:1128-1135.

2. Lee YY, Roberts CL, Dobbins T, Stavrou E, Black K, Morris J, Young J. Incidence and outcomes of pregnancy-associated cancer in Australia, 1994-2008: a population-based linkage study. BJOG. 2012;119:1572-1582.

3. Stojnic J, Jeremic K, Petkovic S, Lazovic G, Stefanovic A. Renal cell carcinoma in pregnancy: a case report. Eur J Gynaecol Oncol 2009;30:347-349.

4. Boussios S, Pavlidis N. Renal cell carcinoma in pregnancy: a rare coexistence. Clin Transl Oncol. 2014;16:122-127.

5. Fiadjoe P, Kannan K, Rane A. Maternal urological problems in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2010;152:13-17.

6. Walker JL, Knight EL. Renal cell carcinoma in pregnancy. Cancer. 1986;58:2343-2347.

7. Fynn J, Venyo AK. Renal cell carcinoma presenting as hypertension in pregnancy. J Obstet Gynaecol. 2004;24:821-822.

8. Donegan WL. Cancer and pregnancy. CA Cancer J Clin. 1983;33:194-214.

9. Sutherland CM, Loutfi A, Mather FJ, Carter RD, Krementz ET. Effect of pregnancy upon malignant melanoma. Surg Gynecol Obstet. 1983;157:443-446.

10. Tsivian M, Rampersaud EN, Jr., Del Pilar Laguna Pes M, Joniau S, Leveillee RJ, Shingleton WB, Aron M, Kim CY, Demarzo AM, Desai MM, Meler JD, Donovan JF, Klingler HC, Sopko DR, Madden JF, Marberger M, Ferrandino MN, Polascik TJ. Small renal mass biopsy - how, what and when: report from an international consensus panel. BJU Int. 2013. doi: 10.1111/bju.12470

11. Tupikowski K, Dembowski J, Zdrojowy R, Lorenz J. Renal-cell carcinoma in pregnancy. Cent Eur J Urol. 2009;62:107-108.

12. Khochikar MV. Management of urological cancers during pregnancy. Nat Rev Urol. 2010;7:195-205.

13. Shellock FG, Kanal E. Safety of magnetic resonance imaging contrast agents. J Magn Reson Imaging. 1999;10:477-484.

14. Wilcox AJ, Weinberg CR, O'Connor JF, Baird DD, Schlatterer JP, Canfield RE, Armstrong EG, Nisula BC. Incidence of early loss of pregnancy. N Engl J Med. 1988;319:189-194.

15. Gladman MA, MacDonald D, Webster JJ, Cook T, Williams G. Renal cell carcinoma in pregnancy. J R Soc Med. 2002;95:199-201.

16. Alouini S. Delay surgery for small renal cancers to week 32 of gestation. Nat Rev Urol. 2010;7:doi:10 1038/nrurol 2010 25-c1.

17. Bettez M, Carmel M, Temmar R, Cote AM, Sauve N, Asselah J, Sabbagh R. Fatal fast-growing renal cell carcinoma during pregnancy. J Obstet Gynaecol Can. 2011;33:258-2561.

18. Gnessin E, Dekel Y, Baniel J. Renal cell carcinoma in pregnancy. Urology. 2002;60:1111.

19. Pentheroudakis G, Pavlidis N. Cancer and pregnancy: poena magna, not anymore. Eur J Cancer. 2006;42:126-140.