title: Conservative treatment of de novo renal carcinoma on kidney graft.
abstract: BACKGROUND
  De novo renal carcinoma in kidney transplants is an uncommon but not exceptional condition and is of significant importance due to the potential for recipient mortality and graft loss. The aim of our study was to determine the management and outcome of these tumors in our Kidney Transplantation Unit.
  
  
  METHODS
  We analyzed cases of de novo kidney tumors among patients who underwent transplantation in the last 17 years in our Kidney Transplantation Unit. We detected 3 cases of clear cell carcinoma and 1 case of papillary carcinoma on the graft. We conducted follow-up on the tumor and renal function and analyzed patient responses to changes in immunosuppression.
  
  
  RESULTS
  Tumorectomy was performed in all cases, and subsequent transplantectomy was required for patients with papillary carcinoma. None of the patients had relevant surgical complications. We also changed the patients' regimen to a proliferation signal inhibitor or mTOR inhibitor and completely withdrew all anticalcineurin agents. With a mean follow-up of 43.5 months (15-61), the 3 patients with clear cell carcinoma survived with good graft function and with no evidence of tumor recurrence. The patient with papillary carcinoma underwent follow-up at another hospital center.
  
  
  CONCLUSIONS
  Conservative surgery along with conversion to a proliferation signal inhibitor appears to be a safe option for treating primary tumors in kidney grafts and offers good oncological and renal function results in the short and medium term.
authors.affiliation: Unidad de Gestión Clínica de Urología-Nefrología, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: irene.cienfuegos@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Cienfuegos-Belmonte
authors.affiliation: Unidad de Gestión Clínica de Urología-Nefrología, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: E
authors.initials: E
authors.lastname: León-Dueñas
authors.affiliation: Unidad de Gestión Clínica de Urología-Nefrología, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Pérez-Valdivia
authors.affiliation: Unidad de Gestión Clínica de Urología-Nefrología, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: R A
authors.initials: RA
authors.lastname: Medina-López
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000628:therapy*; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*
keywords: Carcinoma renal; Cirugía conservadora; Conservative surgery; Inhibidores mTOR; Renal carcinoma; mTOR inhibitors