A case of cervical cancer after living kidney transplantation underwent laparoscopic radical hysterectomy using luminescent urethral catheters (Infrared illumination system)

Abstract

Approximately 1,700 cases of renal transplantation are performed annually, and various diseases may occur due to longterm internal use of postoperative immunosuppressants. We experienced a case of cervical cancer, which is thought to be human papillomavirus (HPV)-related after a living kidney transplantation, underwent laparoscopic radical hysterectomy.A 42-year-old woman underwent living kidney transplantation at the age of 30 years. An increase of CA19-9 was recognized during the follow-up after transplantation. Cervical cytology detected squamous cell carcinoma (SCC); therefore the case was referred to our department. A diagnostic cone resection was performed, and a laparoscopic radical hysterectomy under the diagnosis of cervical cancer stage IB1, was performed. Luminescent ureter catheters were placed on both sides of the ureter, and a DJ stent was placed in the transplant ureter. The right post-peritoneal cavity was difficult to develop due to adhesion. On the left side, radical hysterectomy and pelvic lymph node dissection were performed (pT1bN0M0). Vulvar intra-epithelial neoplasia 3 (VIN3) developed 12 months after the operation and was removed.Following a renal transplantation procedure, close monitoring of the transplanted kidney and transplant ureter is required. Laparoscopic surgery and navigation with a luminescent ureteral catheter are useful methods for avoiding perioperative complications. In addition, in HPV-related cervical cancer, which is considered to be the effect of immunosuppressants, attention should be paid to other new lesions, and careful follow-up is important.