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Kidney Week

Abstract: SA-PO954

Transitional Cell Carcinoma Involving Graft Kidney in a Kidney Transplant Recipient: A Case Report

Session Information

Category: Nephrology Education

  • 1302 Fellows and Residents Case Reports

Authors

  • Jo, Seong il, College of Medicine, The Catholic University of Korea, Seoul, Korea, Daejeon, Korea (the Republic of)
  • Chang, Yoon-Kyung, College of Medicine, The Catholic University of Korea, Seoul, Korea, Daejeon, Korea (the Republic of)
  • Kim, Suk young, College of Medicine, The Catholic University of Korea, Seoul, Korea, Daejeon, Korea (the Republic of)
  • Hong, Yu ah, College of Medicine, The Catholic University of Korea, Seoul, Korea, Daejeon, Korea (the Republic of)
Background

Kidney transplantation (KT) is the treatment option for patients with end stage renal disease (ESRD) to prolong survival and improve quality of life. Although the use of potent immunosuppressive agents increases graft survival in kidney transplantation recipients (KTRs), it may lead to the development of malignancy, including transitional cell carcinoma (TCC). TCC developing in the pelvis of graft kidney is very rare in KTRs

Results

A 40-year-old male visited hospital with complaints of nausea, vomiting and gross hematuria. Eleven years ago, he was diagnosed ESRD of unknown origin, and received a living related KT from his father one year later. Radiologic findings showed a huge polypoid mass in the pelvis of graft kidney with pelvo-calyceal dilation and a 3.3 cm-sized nodule in aortocaval chain and a 2.5 cm-sized nodule in right external iliac chain. Sonography-guided percutaneous needle biopsy of pelvis mass in the graft kidney revealed a low grade urothelial cell carcinoma. Radical graft nephroureterectomy was performed and histopathological diagnosis confirmed as a low grade urothelial carcinoma of graft pelvis and ureter lumen, which invaded to perirenal fat and renal parenchyma with lymphovascular presence (pT3N0M0). The patient started with adjuvant concurrent chemo-radiation therapy and returned to regular hemodialysis.

Conclusion

We report a rare case of TCC in the pelvis of graft kidney with already advanced disease at diagnosis in a young KTR. For the early diagnosis of TCC in KTRs, exposure history to Chinese herb or analgesics should be investigated before KT and high risk population in KTRs should be tightly performed regular postoperative surveillance for TCC and considered of less calcineurin inhibitor-based immunosuppressant protocol.