M. Siebels et al., Large de novo renal cell carcinoma in a 10-year-old transplanted kidney - Successful organ-preserving therapy, TRANSPLANT, 69(4), 2000, pp. 677-679
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.