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NDT Plus Advance Access published online on August 10, 2009
NDT Plus, doi:10.1093/ndtplus/sfp106
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Renal clear cell carcinoma emerging in a transplanted kidney 3 years after return to dialysis. Case report and review of the literature

Ram Elazary1, Avraham Schlager2, Liat Appelbaum3, Gideon Zamir1 and Itzhak Nir1

1 Department of Surgery and Transplantation Unit, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel
2 Departement of Surgery, New York University Hospital, New York, NY, USA
3 Department of Radiology, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel

Correspondence: Ram Elazary; E-mail: ramelazary{at}hadassah.org.il


  Abstract

We present a female patient with end-stage renal disease who was referred to the emergency department with sudden, excruciating pain over the right lower abdomen and flank. Radiologic evaluation following admission revealed a mass, solid in nature, located at the upper pole of the transplanted kidney. The patient was treated with empiric antibiotics and analgesics, and her symptoms subsided over the course of the week. Based on the clinical course and radiological findings, a self-limiting, spontaneous haemorrhage was thought to be the cause of the patient's symptoms. Nevertheless, background malignancy could not be ruled out. Therefore, an interval, elective graft nephrectomy was scheduled. Pathology confirmed the diagnosis of renal clear cell carcinoma.

Key Words: graft • immune suppression • neoplasm • renal cell carcinoma • transplantation

Received for publication May 5, 2009. Accepted for publication July 16, 2009.


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