[Nephron sparing surgery for the treatment of renal carcinoma in a functioning graft: case report]

José Emilio Hernández Sánchez, Angel Gómez Vegas, Jesús Blázquez Izquierdo, Luis San José Manso, Miguel Alonso Prieto, Natalia Pérez Romero, Angel Silmi Moyano
Archivos Españoles de Urología 2007, 60 (3): 295-7

OBJECTIVE: We present nephron sparing renal surgery as a therapeutic option for the conservative treatment of renal cancer by reporting one case of de novo renal cell carcinoma (RCC) presenting in a functioning renal graft.

METHODS/RESULTS: We describe one case of de novo RCC presenting in a functioning renal graft 51 months after transplantation. Tumorectomy was carried out with a margin of normal parenchyma and the base was free of tumor. Definitive pathologic study showed type I papillary renal cell carcinoma, Fuhrman grade 2, pathological stage I with free margins. There were not post operative complications and immunosuppression therapy was not modified. After almost three years of follow-up there is no evidence of tumor recurrence and an adequate renal function.

CONCLUSIONS: Renal graft RCC is rare. Conservative surgery in selected patients may be a safe and effective technique when the tumor appears in a functioning graft, because it offers good oncological control and preserves renal function, avoiding transplant nephrectomy and the need of haemodialysis.

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