A 34-year-old female was diagnosed with a gastrointestinal stromal tumor (GIST) and renal clear cell carcinoma (RCC) during pregnancy, according to a report published in the journal Urology Case Reports.
The patient experienced persistent dyspepsia during her second trimester of pregnancy, which did not resolve with medication. On ultrasound examination, she showed abnormal renal and abdominal masses, with the diagnosis confirmed to be in the stomach by magnetic resonance imaging (MRI).
Cytological evaluation suggested a low-grade GIST and a clear cell variant of RCC that was diagnosed near term, despite being large. Therefore, the medical team decided to delay the surgery until childbirth. She delivered a healthy baby at 34 weeks by lower uterine segment cesarean section (LUCS).
After delivery, the patient was searched for metastasis via contrast-enhanced computed tomography (CECT) of the chest and abdomen. Then, 1 month after LUCS, the medical team performed an exploratory laparotomy. This was followed by left radical nephrectomy and partial gastrectomy.
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“Though the case had a uniquely complicated course and presentation, through proper and timely intervention the maternal health was successfully recovered without any compromise with the health of the baby,” Dey et al wrote.
Histological examinations confirmed the diagnosis of clear cell carcinoma of the left kidney (pT2) with a low-grade stromal tumor of the stomach from possible Mullerian origin.
The co-occurrence of these 2 neoplastic conditions is extremely rare in pregnant women.
“The prognosis of both the mother and the fetus depends on timely diagnosis and proper management of the RCC and the GIST,” Dey et al recognized. Therefore, the availability of a multidisciplinary team is essential.
Dey S, Pakrasi R, Saha D, Datta S. Rapidly progressive growth of renal clear cell carcinoma and gastrointestinal stromal tumor during the 3rd trimester of pregnancy: a clinical and diagnostic dilemma. Urol Case Reports. 2022;40:101891. doi:10.1016/j.eucr.2021.101891