Case report: Undifferentiated (Laryngeal) carcinoma after kidney trtansplant (1965)

Recipient complained of muscle aches, fatigue, vague epigastric pain not responsive to antacids 210 days after kidney transplantation and initial striking recovery. Slight elevation of serum alkaline phosphatase and urea nitrogen, elevated serum creatinine, ASAT, bilirubin. Tenderness in right upper abdominal quadrant with a vague mass in that area. Considerable peripheral and presacral edema. Liver biopsy for suspected cholangiolytic hepatitis contained undifferentiated neoplasm. Recipient died shortly after this diagnosis. The donor was known to have histologically confirmed squamous cell cardinoma of sinus piriformis, well-differentiated at the time of first diagnosis 2 years before donation. Partial laryngectomy and radical neck dissection (after pre-treatment with arterial methotrexate to reduce tumor size) revealed metastatic lymphnodes. Local tumor recurrence 4 months later appeared histologically similar to the Initial tumor but was less well-differentiated. Radiation therapy followed. In the course of another 1.5 years metastases appeared in esophagus and liver. The patient passed away and became kidney donor for the critically ill recipient who was in urgent need of a transplant due to continuous decompensation with heart failure and increasing peripheral neuropathy despite dialysis, Donor autopsy confirmed metastases in trachea, esophagus, liver, lungs, spleen, multiple lymphnodes as well as the non-transplanted contralateral kidney. No residual tumor was found at the primary laryngeal site.