Renal cell carcinoma in renal transplant patients.
OBJECTIVE
To report our experience with renal cell carcinoma in patients with end-stage renal failure receiving dialysis at two institutions that perform a large number of transplantations. Renal cell carcinoma is more frequent in patients with end-stage renal failure treated with dialysis and in renal transplant patients than in the population at large.


METHODS
We reviewed the case histories of 1375 consecutive patients who had transplanted kidneys functioning for more than 1 year.


RESULTS
Eleven renal tumors were found in 10 patients (1.37%); 10 of the tumors (90%) were in the native kidney (9 unilateral and 1 bilateral) and 1 (10%) was in the transplanted kidney. The tumors in the native kidneys were discovered incidentally. Three were in organs removed for treatment of arterial hypertension and the other seven were found by ultrasonography. The tumor in the transplanted kidney was found after nephrectomy for the treatment of hematuria. The tumor types were clear cell in six, papillary in four, and chromophobe in one. Of the 9 patients who were treated with radical nephrectomy, 7 were alive with no evidence of the disease and 2 had died of other causes, also with no evidence of the disease. One patient who already had metastases at the diagnosis did not undergo surgery and died 4 months later.


CONCLUSIONS
The native kidneys of renal transplant patients should be examined by ultrasonography annually because they are at greater risk of renal cell carcinoma. Radical nephrectomy cures those cases in which the tumors are clinically localized and 6 cm or less in size.
Ianhez
Luiz Estevan
LE
Department of Urology, São Paulo University Medical School, São Paulo, São Paulo, Brazil.
Lucon
Marcos
M
Nahas
William Carlos
WC
Sabbaga
Emil
E
Saldanha
Luiz Balthazar
LB
Lucon
Antonio Marmo
AM
Srougi
Miguel
M
D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology; D000231:Adenocarcinoma, Papillary / Q000453:epidemiology; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000601:surgery; D007680:Kidney Neoplasms / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies