Malignant skin neoplasms in patients after kidney transplantation

Abstract

Introduction. The widespread use of modern immunosuppressive therapy schemes has increased the duration of transplanted organ function. However, along with an increase in life expectancy, there is an elevation in malignant neoplasms in patients with a transplanted organ.Objective. To present own clinical experience in the treatment of patients with malignant skin neoplasms after kidney transplantation.Materials and methods. Four patients with malignant skin neoplasms were observed in our clinic from 2010 to 2017. Three of them developed Kaposi's sarcoma between 6 months and 6 years after kidney transplantation, and one was diagnosed with squamous-cell skin cancer 10 years after the operation.Results. After histological verification of Kaposi's sarcoma, excision of neoplasms was performed in two cases, followed by a decrease in the dosage of immunosuppressive drugs. In one case, a complete conversion of immunosuppressive therapy was performed. Stabilization of the oncological process was noted during therapy. However, subsequent deterioration in the function of the transplanted organ was recorded up to a complete loss of function in all patients, which led to the removal of the kidney. A patient with squamous-cell skin cancer underwent surgical treatment with a course of close-focus radiotherapy, but further progression led to a lethal outcome.Conclusion. Kidney transplant recipients receive lifelong immunosuppressive therapy and represent a high-risk group for developing skin malignancies and an increased risk of cancer mortality. Withdrawal of immunosuppressive drugs, i.e. calcineurin inhibitors, is still the main condition for the complete cure of patients with Kaposi's sarcoma but is accompanied by an extremely high probability of loss of function of the transplanted organ.