Robot-assisted management of a complex renal mass in the second trimester of pregnancy: A case report and review of recent literature

Introduction: Renal tumors during pregnancy are rare and present a complex challenge and the need to consider maternal and fetal safety. Case Report: A 32-year-old woman presented with right flank pain at 24+5 weeks of gestation. Ultrasound and magnetic resonance imaging (MRI) revealed a 10 cm hypervascular renal mass extending into the collecting system, initially suspected to be malignant (renal cell carcinoma vs angiomyolipoma). Following multidisciplinary consultation (urology, radiology, and obstetrics), a robot-assisted laparoscopic right nephrectomy was performed with a low pneumoperitoneum pressure (8 mmHg) strategy. Histopathology confirmed an angiomyolipoma. The maternal and fetal courses were without complications. Conclusion: This case shows the feasibility of robot-assisted surgery for complex renal masses during pregnancy and demonstrates the importance of a multidisciplinary team to optimize maternal and fetal outcomes.