title: BK virus-associated urothelial carcinoma of a ureter graft in a renal transplant recipient: a case report.
abstract: BACKGROUND
  Urothelial carcinomas of ureter grafts in renal transplant patients are rare. Here we report our experience with a case of BK virus-associated urothelial carcinoma in a ureter graft.
  
  
  METHODS
  A 47-year-old man developed chronic renal failure secondary to diabetes mellitus and started maintenance hemodialysis in September 2007. Two months later, the patient received a renal transplant from his 70-year-old mother. The patient developed BK virus-associated nephropathy 1 year after transplantation and presented with a decline in renal function and hydronephrosis in the transplanted kidney 4 years 6 months after transplantation. Cystoscopy and retrograde pyelography revealed an irregular filling defect in the ureter graft. Cytologic diagnosis of his urine revealed a high-grade urothelial carcinoma. Computerized tomography showed a cT2 ureteral tumor and no involvement of other organs. The patient subsequently underwent a transplant nephroureterectomy with bladder cuff resection. Histopathologic findings revealed a high-grade urothelial carcinoma, pT2, in the ureter graft with SV40-positive staining. The patient was closely observed without adjuvant chemotherapy therapy and remained disease free 1 year after surgery. Renal transplant recipients with BK virus infection are at high risk of developing urologic malignancies. Close attention is necessary to diagnose post-transplantation urologica malignancies as early as possible.
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Cardiology, Respiratory Medicine, and Nephrology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Oikawa
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. Electronic address: shingorilla2@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Hatakeyama
authors.affiliation: Department of Cardiology, Respiratory Medicine, and Nephrology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fujita
authors.affiliation: Department of Cardiology, Respiratory Medicine, and Nephrology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Murakami
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hagiwara
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Narita
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Noro
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tobisawa
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Yoneyama
authors.affiliation: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoneyama
authors.affiliation: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Koie
authors.affiliation: Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Narumi
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Ohyama
mesh_terms: D001739:BK Virus / Q000472:pathogenicity*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D014513:Ureter / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000209:etiology / Q000821:virology*; D014567:Urography