Urologic Malignancies in Pregnancy

Tumors do occur during pregnancy in all portions of the urologic tract. Fortunately, urologic malignancies are rare during pregnancy. Unfortunately, the presenting symptoms often are misdiagnosed because of confounding symptoms of pregnancy such as hypertension, bleeding, recurrent urinary tract infections, and hydronephrosis of pregnancy. On the other hand, testing and ultrasonography for pregnancy can discover incidental tumors that must be addressed. Evaluation for tumors must include radiological testing. The testing chosen should provide the most information while exposing the fetus to minimal amounts of radiation. Diagnosing malignancies before delivery can be life-saving for the patient and improve survival of the fetus. A high index of suspicion helps prevent missing these tumors. Depending upon the tumor type and stage and gestational age, treatment options are highly variable. All options should be discussed with the patient, and individual treatment plans should be devised based upon risks of immediate therapy versus delayed treatment.