Diagnostic des tumeurs du greffon rénal : à propos de trois cas

Fontaine, Amélie; Thuret, Rodolphe; Garrigues, V.; Taourel, Patrice

doi:10.1016/s0221-0363(10)70064-0

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…There are case reports of coexistent RCC associated with or even within oncocytomas, and we are not aware of any reports indicating that immunosuppressive regimen facilitates oncocytoma malignant transformation [ 4 , 10 ]. Nevertheless, we recommend that clinicians remain mindful that the growth patterns of renal oncocytoma and those of RCC can be similar.…”

Section: Discussionmentioning

confidence: 99%

Oncocytoma managed by active surveillance in a transplant allograft kidney: a case report

et al. 2018

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BackgroundThe ethical implications of the utilization of kidneys with solid renal masses (SRMs) in transplantation are the subject of lively debate in the transplantation community and beyond. One of such implications is that as the life expectancy of renal transplant patients improve, the prevalence of SRMs in donors is likely to increase. We report a case of an oncocytoma in a renal allograft complicating a deceased-donor kidney transplant.Case presentationA 60-year-old woman received and underwent deceased-donor renal transplantation for end-stage renal disease after a waiting-list period of 11 years. Kidney Doppler ultrasound (DUS) of the deceased donor was negative for any nodular lesion. The finding of the DUS, done on postoperative day 1, to assess the patency of the graft, was suspicious for an acute arterial thrombosis but did not reveal any focal irregularities. An ensuing computed tomography (CT) scan did not show any arterial complications but serendipitously revealed a 2.4-cm lesion on the upper pole of the renal allograft, which was not detected during the back-table or ultrasonography monitoring. Histology of the biopsied lesion was consistent with oncocytoma. However, because the eosinophilic variant of chromophobe renal cell carcinoma may morphologically resemble renal oncocytoma, immunohistochemical staining was performed. The results were negative, ruling out chromophobe RCC. After discussing the therapeutic options and potential related outcomes with the patient, we found no reason for resection of the lesion or an allograft nephrectomy, given the low risk of malignant transformation in an oncocytoma. Active surveillance of the benign tumor was done with ultrasonography, every 2 months, for the first year and, then, with magnetic resonance imaging, every year. The patient received mycophenolate-mofetil, tacrolimus, and prednisone throughout the 5-year follow-up period, and the regimen for immunosuppression was not changed despite the presence of the renal mass. After 60 months, we report that none of the radiological findings have shown any morphological changes of the lesion, and the patient is well.ConclusionTo the best of our knowledge, we report the first case of an oncocytoma in a renal allograft complicating a deceased-donor kidney transplant, which was successfully managed by active surveillance.

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Section: Discussionmentioning

confidence: 99%

Oncocytoma managed by active surveillance in a transplant allograft kidney: a case report

et al. 2018

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De novo undifferentiated pleomorphic sarcoma arising from a renal allograft: A case report

Mayor

Wirth

Sanchez-Pareja

et al. 2015

Cancer Treatment Communications

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To the best of our knowledge, this is the first report of an undifferentiated pleomorphic sarcoma arising from a renal graft. Transplantectomy was performed in a 47-year old woman presenting to the emergency room because of general weakness. Preoperative workup revealed a 5.5 cm malignant mass of the graft which was not present on routine ultrasound performed 12 months earlier. Following transplantectomy, local recurrence developed despite complete tumor resection and interruption of immunosuppression. Despite radiation therapy, the outcome was ultimately fatal. Genetic analysis revealed that the tumor had arisen from donor tissue. Annual ultrasound surveillance might not be enough effective to screen for these rare high grade neoplasms.

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Active CMV and EBV infections in renal transplant recipients with unexplained fever and elevated serum creatinine

et al. 2016

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Proper identification of active cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections are helpful for monitoring antiviral treatment in transplant recipients. Qualitative and quantitative CMV, EBV DNA PCR techniques in the context of serological tests are performed for early detection and differentiation of active and latent CMV and EBV infections in renal transplantation. Basically, 129 renal transplanted recipients monitored carefully and hospitalized for unexplained elevated creatinine levels or high fever and 21 of their donors were studied. CMV DNA was detected in 63.5% of the febrile episodes following transplantation and in 46.42% of readmitted patients using qualitative PCR method. In the first group, 15% of the patients and in the second group 42.85% of the patients had copy numbers more than cutoff point (900 copies/mL). Cutoff point had 100% sensitivity and 82.5% specificity for active and symptomatic CMV infection. Only 15.5% of the subjects were positive for EBV infection by qualitative PCR method. Among them 5% had >2000 copies/mL and were symptomatic. One subject with a history of three times hospitalization had higher EBV viral load and developed post-transplant lymphoproliferative disorder. CMV load was significantly correlated with elevated creatinine levels (OR = 3.1, p = 0.006), abnormal heart sounds (OR = 4.7; p = 0.02) and hypertension (OR = 3.6; p = 0.03). Only qRT-PCR could differentiate between latent and active infections and might be clinically useful for monitoring symptomatic CMV and EBV infections and initiation of the antiviral therapy. Elevated creatinine levels, hypertension, and abnormal heart sounds could be considered as main manifestations of HCMV infection in kidney recipients.

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Diagnostic des tumeurs du greffon rénal : à propos de trois cas

Cited by 3 publications

References 13 publications

Oncocytoma managed by active surveillance in a transplant allograft kidney: a case report

Oncocytoma managed by active surveillance in a transplant allograft kidney: a case report

De novo undifferentiated pleomorphic sarcoma arising from a renal allograft: A case report

Active CMV and EBV infections in renal transplant recipients with unexplained fever and elevated serum creatinine

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