High grade, synchronous colon cancers after renal transplantation: Were immunosuppressive drugs to blame?

Recipients of renal transplants are known to have an increased incidence of cancer, which is believed to be related to the use of immunosuppressive dr ugs used to prevent rejection. Although the risks of lymphoma and Kaposi's sarcoma are clearly increased in this setting, the association with colon c ancer is controversial. We report a 44-yr-old woman, 20 yr post-renal trans plant, and with no family history of colorectal cancer or polyps, who was f ound to have synchronous, poorly differentiated colon cancers associated wi th extensive abdominal lymph node, bone marrow, and bone (skull) metastasis . The long term immunosuppressive drugs that she had received may have been an important factor in her tumor development and/or progression. Our case and literature review suggest a possible mild, increased risk of colon canc er development in patients after renal transplantation. (C) 1999 by Am. Col l. of Gastroenterology.