title: First case report of acute myeloid sarcoma post renal transplant.
abstract: BACKGROUND
  Although lymphoproliferative disorders are well-described and known entities post renal transplantation, acute myeloid sarcoma is a rare if ever reported occurrence in this setting. Immunosuppressive therapy is thought to be the main culprit in these cases.
  
  
  METHODS
  A 51-year-old man underwent renal transplantation 3.5 years earlier from a living unrelated donor. His posttransplant history was relevant for a road traffic accident after which a rise in the serum creatinine warranted 4 renal biopsies over a period of 7 months. The biopsies showed mainly acute tubular injury with sharp increase of the interstitial fibrosis and tubular atrophy between the first and the last biopsies. The patient was put on hemodialysis for 7 months, after which the allograft started functioning. The patient was followed a routinely, until he re-presented with increased creatinine and was found to have intra- and perirenal masses. Biopsies revealed acute myeloid sarcoma. The patient was started on fludarabine and cytosine arabinoside followed by All-trans retinoic acid and arsenic trioxide.
  
  
  CONCLUSIONS
  The patient was disease free on his last positron emission tomography 1 year after the initial diagnosis.
authors.affiliation: Department of Internal Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: M
authors.initials: M
authors.lastname: AlGhunaim
authors.affiliation: Department of Internal Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: A
authors.initials: A
authors.lastname: AlSuwaida
authors.affiliation: Department of Pathology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. Electronic address: snz24@yahoo.com.
authors.forename: S N
authors.initials: SN
authors.lastname: Zaidi
authors.affiliation: Department of Pathology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: H
authors.initials: H
authors.lastname: Kfoury
mesh_terms: D003404:Creatinine / Q000097:blood; D042381:Granulocyte Precursor Cells / Q000378:metabolism; D006651:Histocytochemistry; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D023981:Sarcoma, Myeloid / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D066027:Transplant Recipients; D014184:Transplantation, Homologous
chemical_list: D003404:Creatinine