Clear cell renal carcinoma presenting as a bleeding cyst in pregnancy: inaugural manifestation of a von Hippel-Lindau disease

Clin Nephrol. 2008 Mar;69(3):224-8. doi: 10.5414/cnp69224.

Abstract

Von Hippel-Lindau (VHL) disease is a dominant autosomal disorder inducing the development of many tumors, such as hemangioblastomas in the central nervous system and retina, cysts or tumors (benign or malignant) in the kidneys and/or the pancreas. We report the case of a pregnant woman who presented with a voluminous hemorrhagic cyst of the right kidney with an exophytic lesion detected in the lower median part of the cyst wall. As an anamnestic inquiry resulted in a familial history of VHL disease, a screening imaging was performed and detected three medullary hemangioblastomas. Considering the active bleeding of the renal cyst and its potential malignancy, a unilateral nephrectomy was carried out after pregnancy interruption. Histological analysis confirmed a multilocular clear cell renal carcinoma. This case underlines the importance of screening procedures such as abdominal ultrasonography and medullary magnetic resonance imaging in all pregnant women with a familial history of VHL disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carcinoma, Renal Cell / complications*
  • Carcinoma, Renal Cell / diagnosis
  • Carcinoma, Renal Cell / surgery
  • Diagnosis, Differential
  • Female
  • Hematuria / diagnosis
  • Hematuria / etiology*
  • Hematuria / surgery
  • Humans
  • Kidney Diseases, Cystic / diagnosis*
  • Kidney Neoplasms / complications*
  • Kidney Neoplasms / diagnosis
  • Kidney Neoplasms / surgery
  • Magnetic Resonance Imaging
  • Nephrectomy / methods
  • Pregnancy
  • Pregnancy Complications, Neoplastic*
  • von Hippel-Lindau Disease / complications*
  • von Hippel-Lindau Disease / diagnosis