title: De novo renal cell carcinoma in a kidney allograft 20 years after transplant.
abstract: Renal cell carcinoma (RCC) in a kidney allograft is rare. We report the successful diagnosis and treatment of a de novo RCC in a nonfunctioning kidney transplant 20 years after engraftment. A 54-year-old man received a kidney transplant from his mother when he was 34 years old. After 10 years, chronic rejection resulted in graft failure, and the patient became hemodialysis-dependent. Intravenous contrast-enhanced computed tomography (CT) for the evaluation of gastrointestinal symptoms revealed a solid 13 mm tumor in the kidney graft. The tumor was confirmed on ultrasound examination. This tumor had not been detected on a surveillance noncontrast CT scan. Needle biopsy showed that the tumor was an RCC. Allograft nephrectomy was performed. Pathological examination showed that the tumor was a Fuhrman Grade 2 RCC. XY-fluorescence hybridization analysis of the RCC showed that the tumor cells were of donor origin. One year after the surgery, the patient is alive and has no evidence of tumor recurrence. Regardless of whether a kidney transplant is functioning, it should periodically be imaged for RCC throughout the recipient's lifetime. In our experience, ultrasonography or CT with intravenous contrast is better than CT without contrast for the detection of tumor in a nonfunctioning kidney transplant.
authors: Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Masataka
authors: M
authors: Banshodani
authors: Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Hideki
authors: H
authors: Kawanishi
authors: Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Seiji
authors: S
authors: Marubayashi
authors: Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Sadanori
authors: S
authors: Shintaku
authors: Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Misaki
authors: M
authors: Moriishi
authors: Department of Pathology, Faculty of Human Culture and Science, Prefectural University of Hiroshima, 1-1-71 Ujina-Higashi, Minami-ku, Hiroshima 734-8558, Japan.
authors: Fumio
authors: F
authors: Shimamoto
authors: Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Shinichiro
authors: S
authors: Tsuchiya
authors: Department of Surgery, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajimacho, Naka-ku, Hiroshima 730-8655, Japan.
authors: Kiyohiko
authors: K
authors: Dohi
authors: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institution of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
authors: Hideki
authors: H
authors: Ohdan