title: Prostate Cancer Metastatic to the Renal Allograft: A Case Report.
abstract: Malignancy is a leading cause of morbidity and mortality in organ transplant recipients who receive immunosuppression. Cancers associated with viruses such as nonmelanotic skin cancer and Kaposi sarcoma occur in allograft recipients at rates that far exceed that in the general population. The increased risk and tumor type may depend not only on degree of immune system modulation but also on the type of organ transplanted. In kidney transplant recipients, the risk of cancers such as prostate and breast does not seem to be increased. However, these cancers tend to be advanced and aggressive. The management of these cancers is similar to the general population with the additional consideration for reduction in immunosuppression and conversion to sirolimus. Given the increased survival of both transplanted organs as well as organ recipients along with the increased number of older recipients, the diagnosis of prostate cancer in the older male organ recipient is increasing. The long-term outcomes using current treatment guidelines for prostate cancer in these individuals are not clear. We report a case of known localized prostate cancer in a renal transplant recipient presenting with metastasis diagnosed as tumor infiltration of the allograft. Our patient, upon initial diagnosis of cancer, opted for radiation with eventual androgen-deprivation therapy. This unusual site of prostate cancer spread heightens the need for awareness among providers as well as the need for further studies of the outcomes in these patients undergoing treatments designed using guidelines developed for those with normally functioning immunity.
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: A
authors.initials: A
authors.lastname: Alaini
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: P
authors.initials: P
authors.lastname: Singh
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: R
authors.initials: R
authors.lastname: Shah
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: E
authors.initials: E
authors.lastname: Fischer
authors.affiliation: New Mexico Veterans Administration Health Care System, Albuquerque, New Mexico, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ganta
authors.affiliation: New Mexico Veterans Administration Health Care System, Albuquerque, New Mexico, USA.
authors.forename: T
authors.initials: T
authors.lastname: Barrett
authors.affiliation: Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA; New Mexico Veterans Administration Health Care System, Albuquerque, New Mexico, USA. Electronic address: KServilla@salud.unm.edu.
authors.forename: K
authors.initials: K
authors.lastname: Servilla
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D006801:Humans; D007680:Kidney Neoplasms / Q000556:secondary*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen