Zero Ischemia Partial Nephrectomy in Pregnancy

Renal cell carcinoma (RCC) represents 2-3% of all cancers. Although RCC is rare, it is the most common urologic malignancy reported in pregnancy. Modality and timing of treatment during pregnancy represent a dilemma. A 37-year pregnant woman at 12th gestational week was referred by the obstetrician. MRI showed exophytic, heterogeneous renal mass of 50x48x45 mm, located in the lower pole of right kidney, which was interpreted as RCC. The patient underwent retroperitoneal open partial nephrectomy (PN). Operation time was 47 minutes with zero ischemia time. Obstetrics consultation confirmed survival of fetus after surgery. The patient was discharged on the third day, uneventfully. Histopathological examination revealed stage 1b clear-cell renal carcinoma, Furhman grade 2 with maximum diameter of 5 cm, no invasion of capsule, negative margine and without necrosis. Open techniques are better in pregnant patients with renal tumors because of short surgical and ischemia time and minimal bleeding.