Regular ultrasound examination of transplanted kidneys allows early diagnosis of renal cell carcinoma and conservative nephron sparing surgery

Paolo Lentini, Antonio Granata, Antonino Ciancio, Maurizio Gallieni
Archivio Italiano di Urologia, Andrologia 2011, 83 (4): 195-9

INTRODUCTION: The development of malignancies is a relevant long-term complication of organ transplantation. Carcinoma of native kidney accounts for up to 5% of all malignancies found in transplant recipients. Primary clear cell type renal cell carcinoma (RCC) usually arises in the native kidneys. Its occurrence in the renal allograft has been reported infrequently.

CASE PRESENTATION: We report a rare case of de novo RCC in a kidney allograft in a 41 years-old woman. Routine ultrasonography denoted a poorly marginated hypoechoic mass at the inferior pole of transplanted organ, confirmed by computed tomography which showed a lesion of 32 mm in diameter with characteristic radiological signs of RCC. The patient underwent nephron sparing surgery (NSS). At histological examination the tumor was T1-T2, N0, M0 with negative margins. At five years after NSS no significant impairment of renal function or recurrence was observed.

CONCLUSION: Primary carcinomas of the kidney can be detected after transplantation in the native or transplanted kidney. According to the European Guidelines on the long-term management of kidney transplantation, all recipients should have regular ultrasonography of native and allograft kidneys to screen for cancer, which occurs at a much higher incidence in transplanted patients. NSS is a safe and efficient procedure for the treatment of RCC in renal graft, resulting in the preservation of renal function and in long-term cancer control.

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