Fatal fast-growing renal cell carcinoma during pregnancy.

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.