Large de novo renal cell carcinoma in a 10-year-old transplanted kidney - Successful organ-preserving therapy

Background. A recent review of the Cincinnati Transplant Tumor Registry rec orded 24 de novo renal cell carcinomas developing in renal allografts. Howe ver, late development of these tumors after transplantation is very rare. O nly four reports exist regarding conservative surgery on kidney transplant tumors. Methods. This is a report on a case of a large 6-cm de novo renal cell carc inoma in a 10-year-old transplanted kidney. Optimal therapy by transplant n ephrectomy or tumor enucleation was discussed. Results. Partial resections or enucleations of renal cell carcinoma are sti ll less than ideal in carcinomas larger than 3 cm considering the higher ri sk of local recurrence. But the recipient in this case had done so well and had had such a high quality of life after transplantation that partial nep hrectomy as therapy of choice was selected. Now the patient is 2 years tumo r free. Conclusion. The case report demonstrates that in certain select cases of la rge tumors, organ-preserving surgery could be an alternative approach in co mbining complete tumor removal with preservation of graft function.