Introduction and importance: Renal masses during pregnancy are rare and present a significant diagnostic and therapeutic challenge. Timely recognition and appropriate multidisciplinary management are essential to ensure favorable outcomes for both mother and fetus. This case highlights the successful surgical management of a large renal mass diagnosed during the second trimester. Case presentation: A 38-year-old woman, gravida 4 para 1, presented at 19 + 4 weeks of gestation with right flank pain and gross hematuria. Imaging revealed a 14.5 cm solid, vascular renal mass. MRI confirmed features suggestive of renal cell carcinoma. After multidisciplinary consultation and counselling, the patient underwent a right nephrectomy at 19 + 5 weeks gestation. Histopathology confirmed clear cell renal cell carcinoma. The pregnancy continued without complication, and the patient delivered a healthy infant via normal vaginal delivery at term. Clinical discussion: Non-obstetric abdominal surgery during pregnancy, particularly in the second trimester, is generally safe when clinically indicated. This case demonstrates the critical role of coordinated care among obstetricians, urologists, and anesthesiologists in managing malignancies in pregnancy. MRI served as a valuable, non-invasive diagnostic tool. Surgical intervention led to complete tumor resection without compromising maternal or fetal well-being. Conclusion: Nephrectomy during the second trimester can be safely performed with favorable outcomes in pregnant patients with renal tumors. Early diagnosis and multidisciplinary management are key to optimizing maternal and fetal prognosis in such complex clinical scenarios.
Shrateh et al. (Thu,) studied this question.
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