Status:
Ready to upload
Record number:
2039
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for urothelial carcinoma (Council of Europe, 2022):
No literature exists regarding newly diagnosed urothelial cancer and organ donation. Therefore, the highest caution is recommended, and the advice of a urologist may be sought in assessing the individual donor tumour transmission risk. National recommendations should be followed since they vary in accepting these tumours. Urothelial cancer in the donor history: Strict follow-up must have been provided after primary diagnosis because these tumours may be multicentric and tend to recur, with a need for repeated cystoscopy and TUR-B, and for restaging. Kidney transplantation will be associated with increased risk, but this has not been classified in the literature yet. After a disease-free interval > 5 years, the transmission risk of invasive urothelial cancer will depend on the probability of cure and must be assessed individually before accepting a potential organ donor. No specific recommendations are available from the literature.
Time to detection:
1 year
Alerting signals, symptoms, evidence of occurrence:
Abdominal pain, distension, nausea and vomiting
Demonstration of imputability or root cause:
CT scan showed a renal mass. Biopsy showed a sarcomatoid carcinoma with squamous differentiation, shown to be arising from the right renal pelvis on pathologic examination following transplant nephrectomy. Presumed to be of donor origin because of location (in donor tissue). Whether or not it was present prior to transplant not proven, although short time to invasive carcinoma suggests that it probably was.
Imputability grade:
2 Probable
Groups audience:
References:
Suggest new keywords:
Malignancy
Case report
Kidney transplant
Urothelial (transitional cell) carcinoma
Reference attachment:
Suggest references:
Dhakal P, Giri S, Siwakoti K, Rayamajhi S, Bhatt VR. Renal Cancer in Recipients of Kidney Transplant. Rare Tumors. 2017;9(1):6550.
Note:
Carl-Ludwig: Agree to Michael - urothel and not renal cell CA; they also mention a sarcomatid component. Of note, the recipient survived without the typical course of urothel-Ca when no stop of immunosuppression and no chemotherapy. I would upload with the safety warning, that we must be careful when comparing malignancies in renal grafts.
Expert comments for publication:
The authors present this as a case of renal cancer but it is actually a renal pelvic urothelial carcinoma and not a renal cell carcinoma. They also combine the discussion of renal cell and urothelial carcinomas, so the reader should be careful in interpreting their frequency discussion and cross check the references to determine whether a particular frequency corresponds to renal cell or urothelial carcinoma.