Nephron-sparing surgery of a low grade renal cell carcinoma in a renal allograft 12 years after transplantation.
Renal cell carcinoma (RCC) occurring in renal allografts after cadaveric kidney transplantation has rarely been observed. RCC accounts for 2.3% of all malignancies in the general population, but up to 4.8% of malignancies in renal transplant recipients. Most have been reported in the patient's own diseased kidneys, whereas RCC in the renal allograft occur in only 10%. Here, we describe an organ-preserving surgical technique of a malignant renal tumor in a kidney allograft using a harmonic scalpel (Ultracision) for tumor enucleation. Furthermore we demonstrate by DNA microsatellite analysis the tumor's genetic origin as donor related. Collectively, we suggest that patients with a well defined low grade RCC in the kidney allograft and altogether low malignancy and good allograft function should only undergo an organ-preserving procedure and short-term postoperative screening.
Mundel
Thomas M
TM
Division of Matrix Biology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA. tmundel@bidmc.harvard.edu
Schaefer
Karl-Ludwig
KL
Colombo-Benkmann
Mario
M
Dietl
Karl-Heinz
KH
Diallo-Danebrock
Raihana
R
Senninger
Norbert
N
D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D018895:Microsatellite Repeats; D008875:Middle Aged; D009399:Nephrons / Q000601:surgery*; D014184:Transplantation, Homologous