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Maggen C, Linssen J, Gziri MM, Zola P, Cardonick E, de Groot CJM, Garcia AC, Fruscio R, Drochytek V, Van Calsteren K, Albersen M, Amant F. Renal and Bladder Cancer During Pregnancy: A Review of 47 Cases and Literature-based Recommendations for Management. Urology 2020; 151:118-128. [PMID: 33203520 DOI: 10.1016/j.urology.2020.08.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/23/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To provide contemporary gestational age-specific recommendations for management, a retrospective series of patients with renal or bladder cancer during pregnancy is reported. METHODS Obstetric and oncological data of pregnant patients with a diagnosis of renal or bladder cancer were selected from the worldwide registry of the International Network of Cancer, Infertility and Pregnancy. In addition, the literature was reviewed for recent case reports since last reviews in 2014 for renal cancer and 2004 for bladder cancer. RESULTS International Network of Cancer, Infertility and Pregnancy registered 22 cases (14 renal cancer and 8 bladder cancer), diagnosed between 1999 and 2017, and the literature reported 15 cases with renal cancer and 10 cases with bladder cancer between 2004 and 2019. Most common symptoms for renal and bladder cancer were pain (28%) and hematuria (66%), respectively. In more than half of the patients, surgical treatment was performed during pregnancy. Preterm deliveries were mostly medically induced (12 of 17, 71%) and all patients with a planned delivery before 34 weeks had advanced cancer. For renal and bladder cancer respectively, 79% and 87% of patients obtained complete remission. Advanced cancer stages had worse prognosis; 3 of 7 patients with known follow-up deceased within 15 months after diagnosis. CONCLUSION Gestational age at diagnosis determines further management of renal and bladder cancers during pregnancy. Advanced stages challenge decision-making. The maternal needs for immediate treatment, and the neonatal risks including the impact of a preterm delivery should be discussed in a multidisciplinary setting while respecting the patient's autonomy.
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Affiliation(s)
- Charlotte Maggen
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jasmijn Linssen
- Department of Gynecological Oncology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Mina Mhallem Gziri
- Department of Obstetrics, Cliniques Universitaires St Luc, UCL, Sint-Lambrechts-Woluwe, Belgium
| | - Paolo Zola
- Department Surgical Sciences, University of Torino, Torino, Italy
| | - Elyce Cardonick
- Department of Obstetrics and Gynecology, Cooper, University Health Care, Camden, New Jersey, USA
| | - Christianne J M de Groot
- Department of Obstetrics and Gynecology, and Amsterdam Reproduction and Development, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Alvaro Cabrera Garcia
- Hospital Regional de Alta Especialidad de Ixtapaluca (HRAEI) " Reference clinic for hemato-oncological diseases during pregnancy CREHER" Estado de México, México
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan - Bicocca, San Gerardo Hospital, Monza, Italy
| | - Vit Drochytek
- Faculty Hospital Kralovske, Vinohrady and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Amant
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium; Department of Gynecological Oncology, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Department of Gynecological Oncology, Amsterdam University Medical Centres, Amsterdam, The Netherlands and the Department of Gynecology, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Tyagi S, Nelivigi G, Bhagat S. Management of Bladder Cancer in the Second Trimester of Pregnancy. J Obstet Gynaecol India 2018; 69:20-23. [PMID: 30956485 DOI: 10.1007/s13224-018-1142-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/25/2018] [Indexed: 10/14/2022] Open
Affiliation(s)
- Shefali Tyagi
- Gynecology and Obstetrics, Cloudnine Bellandur, Bengaluru, India
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Töz E, Ince O, Apaydın N, Gürbüz T, Dayanıklı N, Ayaz D. A case of bladder endometriosis that became symptomatic during the third trimester. Case Rep Womens Health 2015; 6:1-3. [PMID: 29629304 PMCID: PMC5885998 DOI: 10.1016/j.crwh.2015.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 02/26/2015] [Indexed: 11/05/2022] Open
Abstract
Background The urinary tract endometriosis is observed in 1–2% of the patients and in 90% of these cases, there are endometriotic nodules in the bladder. With respect to knowledge, it is generally believed that pregnancy cures endometriosis. However in this case, symptoms developed during the third trimester of pregnancy. Case report We report a case of 31 year old, 30 week pregnant woman with a vegetative mass with 33 × 33 × 21 mm dimensions and irregular borders on the posterior wall of the bladder. After the cesarean section, the vegetative and superiorly localized mass on the internal wall of the bladder was excised with partial bladder excision. The patient had no other apparent findings of pelvic endometriosis at operation but the pathology result indicated endometriosis. Conclusion Although this case shows that endometriosis may become symptomatic during pregnancy, it has to be underlined that it cannot be discerned whether it is consequent to progress of the disease or to pregnancy-mediated modifications of a pre-existing lesion. Endometriosis may become symptomatic during pregnancy. When a mass detected in the bladder, the most appropriate tool for diagnosis is cystoscopic biopsy. Cystoscopy during pregnancy may fail to detect bladder nodules. With decidual changes endometriotic nodules in the bladder can mimic malignancy during pregnancy.
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Affiliation(s)
- Emrah Töz
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Onur Ince
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Nesin Apaydın
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Tutku Gürbüz
- Department of Gynecology and Obstetrics, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Nihat Dayanıklı
- Department of Urology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
| | - Duygu Ayaz
- Department of Pathology, İzmir Tepecik Education and Research Hospital, İzmir, Turkey
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