Department of Medical Oncology, Medway NHS Foundation Trust, Kent, U.K.
GKT School of Medicine, King's College London, London, U.K.
Anticancer Res. 2023 Sep;43(9):3871-3880. doi: 10.21873/anticanres.16574.
Gestational renal cell carcinoma (RCC) is an uncommon occurrence and presents a diagnostic and clinical challenge for healthcare providers. The manifestation of gestational RCC often lacks overt symptoms and can mimic physiological changes and disorders associated with pregnancy. Frequently, patients are asymptomatic, and the condition is detected during routine antenatal ultrasonography. However, the options for imaging modalities and treatment are limited due to the potential risks of harm to the developing fetus and interruption of pregnancy. Throughout the management of pregnant patients with RCC, both maternal and neonatal risks must be carefully considered, while respecting the patient's autonomy. Currently, there are no internationally or nationally recognized evidence-based guidelines for managing gestational RCC, highlighting the need for a multidisciplinary approach to treatment. Advances in surgical techniques have resulted in a shift from open surgeries to laparoscopic radical or partial nephrectomy procedures, with robotic-assisted approaches also gaining popularity. In cases of metastatic gestational RCC, termination of the pregnancy may be considered, and the appropriate treatment of RCC should be the priority. This article aims to provide a comprehensive review of the epidemiology, aetiology, clinical presentation, diagnosis, prognosis, and management of gestational RCC.
妊娠性肾细胞癌（RCC）较为罕见，对医疗保健提供者的诊断和临床治疗提出了挑战。妊娠性 RCC 的表现常缺乏明显症状，可能与妊娠相关的生理变化和疾病相混淆。患者通常无症状，该疾病是在常规产前超声检查中发现的。然而，由于对发育中的胎儿造成伤害和妊娠中断的潜在风险，影像学检查和治疗的选择有限。在妊娠合并 RCC 患者的管理过程中，必须仔细考虑母婴风险，同时尊重患者的自主权。目前，国际或国家尚未制定管理妊娠性 RCC 的循证指南，这突出了需要采取多学科方法进行治疗。手术技术的进步已促使人们从开放性手术转向腹腔镜根治性或部分肾切除术，机器人辅助方法也越来越受欢迎。对于转移性妊娠性 RCC，可能需要终止妊娠，应优先考虑 RCC 的适当治疗。本文旨在全面综述妊娠性 RCC 的流行病学、病因、临床表现、诊断、预后和管理。
