LAUSR

Renal neoplasms in pregnancy are a rare entity, benign as well as malignant. They confront the clinician with an uncomfortable and unfamiliar dilemma. There is no clarity about the ideal treatment approach and time frame for surgery during pregnancy. Using a retrospective chart review of our own clinical database (1994-2017), we present a cohort of 9 women with a newly diagnosed renal neoplasm during or within the first month after pregnancy. Three patients presented a benign neoplasm and 6 showed a malignant renal cell carcinoma. Our results illustrate an unprecedented higher prevalence of atypical and syndromic renal tumors because half of the cohort with malignancy presented with a chromophobic type. Tuberous sclerosis complex was present in 2 cases of the cohort with benign neoplasm. The favored surgical technique was partial nephrectomy (44%), followed by radical nephrectomy (33%). To our knowledge, no case series of this magnitude has been reported. The unprecedented inclusion of benign neoplasm implies a scope beyond malignancy, tackling the diagnostic dilemma of an incidental renal mass in pregnancy. These diagnostic and therapeutic challenges are discussed, and trimester-determined solutions are elaborated. A low threshold for attribution of symptoms to nonobstetric etiologies should be used in pregnant patients.