How is renal cell carcinoma (RCC) evaluated during pregnancy?

Updated: Dec 13, 2018
  • Author: Deborah A Baumgarten, MD, MPH; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

When RCC is suggested in a pregnant patient, US should be considered first for imaging, especially in the first trimester. CT also can be useful, and the radiation exposure to the fetus is justifiable, especially if the clinical picture is confusing; any fetal damage is unlikely at the radiation doses typically used. The dose should be kept to a minimum by increasing the pitch and decreasing the microamperes and avoiding scanning the pelvis if possible. MRI is good for detecting, characterizing, and staging renal masses and avoids the exposure to ionizing radiation; however, intravenous gadolinium contrast cannot be used.

The use of the most appropriate and accurate diagnostic method (contrast-enhanced CT or MRI) and the most appropriate treatment of the mother is most likely to result in long-term benefit to the fetus. Nephrectomy can be performed with the least morbidity to the mother and fetus in the second trimester and is probably preferable to leaving a malignancy untreated throughout pregnancy.


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