title: Kidney-autotransplantation before radiotherapy: a case report.
abstract: BACKGROUND
  A 28-year-old man suffering from a Ewing tumour arising from the 9th-11th ribs with infiltration of neuroforamina without distant metastases was planned to receive radiotherapy following primary intralesional surgery and induction chemotherapy. Due to pleural infiltration and effusion, a hemithorax irradiation with a sequential boost to the primary tumour site had to be administered. Different treatment planning variants failed to provide sufficient radiotherapy planning in view of target volume coverage and avoidance of organs at risk, especially due to high calculated radiation doses potentially compromising the left kidney.
  
  
  METHODS
  To prevent left kidney organ exposure, an autotransplantation of the left kidney into the right fossa iliaca was performed. An infiltration of the kidney was initially excluded.
  
  
  RESULTS
  Postoperatively, a renal scintigraphy showed a normal function of both kidneys allowing sufficient radiotherapy treatment planning. Target volume coverage was easily obtained using a combination of hemithorax irradiation and a sequential boost by an intensity-modulated-radiotherapy technique.
  
  
  CONCLUSIONS
  In difficult individual treatment situations, surgical transpositions as well as organ autotransplantation might be useful in reducing radiotherapy organ dose levels.
authors: Department of Radiotherapy, University Hospital Münster, Albert-Schweitzer-Str.33, D-48129 Münster, Germany. Tobias.Boelling@ukmuenster.de
authors: Tobias
authors: T
authors: Bölling
authors: Kirsten
authors: K
authors: Janke
authors: Heiner H
authors: HH
authors: Wolters
authors: Marco
authors: M
authors: Glashörster
authors: Iris
authors: I
authors: Ernst
authors: Normann
authors: N
authors: Willich
authors: Jens
authors: J
authors: Brockmann
authors: Stefan
authors: S
authors: Könemann
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000528:radiation effects / Q000601:surgery; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated; D012512:Sarcoma, Ewing / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D014182:Transplantation, Autologous