Renal cell carcinomas arising from the allograft and bilateral native kidneys

Abstract

Abstract:We present the case of a young lady who developed renal cell carcinomas (RCC) in the allograft and bilateral native kidneys metachronously within one year. She received a living donor kidney transplantation from her father. A solid tumor of 4 cm in diameter was uncovered first in the allograft kidney 103 months after transplantation, and was treated with graftectomy. Six months after graftectomy, a right renal tumor measuring 3.5 cm and left renal tumors emerged in the native kidneys. She underwent laparoscopic right and left radical nephrectomy in separate sessions. The pathological diagnosis in the allograft and right renal tumors was clear cell RCC with eosinophilic cytoplasm and that in the left kidney was clear cell carcinoma. Fluorescence in situ hybridization and human leukocyte antigen typing showed that each tumor was most probably primary disease. She was free of disease 18 months postoperatively. This is the first report on RCC arising both in the allograft and bilateral native kidneys.

Bilateral renal cell carcinoma of the native kidneys in a 16-year-old boy: Report of a rare case and review of the literature

“…All of the previously reported bilateral native RCCs had the same experience, and there is no consensus in the literature for post-nephrectomy medical and oncologic treatment. [3][4][5][6][7][8] As a conclusion, bilateral RCC in the native kidney is rare and its occurrence in a teenager is even more uncommon. The prognosis is good; however, the maintenance treatment for the allograft kidney is controversial.…”

“…1,8 Most of bilateral RCCs in the previously reported cases have presented with hematuria. 5–8 Our patient presented with recurrent urinary tract infection (UTI). The histologic subtype of the RCC is different from RCC in non-transplanted patients, and the incidence of papillary type RCC is higher than expected, that is, in the seven patients reported in the literature plus our case, four tumors were papillary (50%).…”

“…We have conducted a thorough search in the English language literature of the last 20 years, and there were less than 10 reported bilateral RCCs in the native kidneys of renal transplant patients, all of them transplanted after the age of 18 years, having the RCC after the age of 22 years. [5][6][7][8] Our patient is the youngest reported renal transplant patient (transplanted at the age of 10 years) who developed bilateral RCC, 6 years after transplant with no underlying medical disease and a completely normal-functioning allograft.…”