妊娠期快速进展性致命性肾细胞癌

Fatal fast-growing renal cell carcinoma during pregnancy.

作者信息

Bettez Mathieu, Carmel Michel, Temmar Rabbia, Côté Anne-Marie, Sauvé Nadine, Asselah Jamil, Sabbagh Robert

机构信息

Urology Division, Department of Surgery, University of Sherbrooke, Sherbrooke, QC.

出版信息

J Obstet Gynaecol Can. 2011 Mar;33(3):258-61. doi: 10.1016/s1701-2163(16)34827-7.

DOI:10.1016/s1701-2163(16)34827-7

PMID:21453566

Abstract

BACKGROUND

Renal cell carcinoma (RCC) during pregnancy is rare. Volume doubling time for RCC is estimated to be 72 weeks.

CASE

A 28-year-old woman was assessed for macroscopic hematuria at 21 weeks' gestation. A renal ultrasound revealed a 3.4 cm right renal mass. After MRI, the most likely diagnosis seemed to be angiomyolipoma. The patient opted for conservative management, and the pregnancy continued to almost 36 weeks, at which time the mass had tripled in size. Laparoscopic nephrectomy was performed four days after delivery, and pathological examination revealed a 9.3 cm renal cell carcinoma. Three months later, multiple metastases were identified, which were resistant to targeted therapies. The patient died 12 months postpartum.

CONCLUSION

Although renal tumours during pregnancy have been reported, this is the first report of a fatal fast-growing renal tumour.

摘要

背景

妊娠期肾细胞癌（RCC）较为罕见。RCC的体积倍增时间估计为72周。

病例

一名28岁女性在妊娠21周时因肉眼血尿接受评估。肾脏超声检查发现右肾有一个3.4厘米的肿块。磁共振成像（MRI）检查后，最可能的诊断似乎是肾血管平滑肌脂肪瘤。患者选择保守治疗，妊娠持续至近36周，此时肿块大小增至原来的三倍。产后四天进行了腹腔镜肾切除术，病理检查显示为9.3厘米的肾细胞癌。三个月后发现多处转移，对靶向治疗耐药。患者产后12个月死亡。