Katayama Hiromichi, Ito Akihiro, Kakoi Narihiko, Shimada Shuichi, Saito Hideo, Arai Yoichi
Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Urol Int. 2014;92(1):122-4. doi: 10.1159/000354351. Epub 2013 Nov 21.
Renal cell carcinoma (RCC) during pregnancy is rare, and the treatment of this condition requires appropriate steps to treat both the patient and the fetus. To the best of our knowledge, this is the first report to describe a case of RCC with tumor thrombus in the inferior vena cava (IVC) occurring during pregnancy. The affected 46-year-old pregnant woman with placenta previa was clinically diagnosed with cT3bN0M0 RCC at 25 weeks gestation. Therapeutic considerations included risk of sudden pulmonary embolism, risk of thrombosis or intraoperative hemorrhage, and safe delivery of the fetus. After extensive consultation with obstetricians and pediatricians, the surgical management was divided into two steps. First, the patient underwent Caesarean section and simultaneous hysterectomy at 26 weeks gestation. Then, 16 days after delivery, when hemodynamics and hemostasis had improved due to termination of gestation, the patient underwent radical nephrectomy with concomitant IVC thrombectomy.
