Management of Renal Cell Carcinoma and Other Renal Masses in the Kidney Graft

Abstract

Purpose of Review Renal masses in the kidney graft pose an important clinical dilemma, balancing graft function against the need for cancer control. Recent Findings Donor origin cancers in the renal graft can be classified as 'donor transmitted' or 'donor derived'. The landmark TracerX Renal changed our understanding of renal cell carcinoma oncogenesis, demonstrating that key mutations in childhood lead to clinically apparent tumours in later life. Identified pre-operatively, contemporary evidence suggests that masses excised prior to transplantation result in acceptable oncologic safety and graft function. Identified post-operatively management mirrors that for a mass in a solitary kidney in the non-transplant population, with focus on a nephron-sparing approach. Summary With growing number of kidney transplants each year, ageing donors, and increasing graft survival, masses in the renal graft are likely to become a more prevalent clinical conundrum.

A Rare Case of Donor-Derived Renal Cell Carcinoma in a Kidney Transplant Recipient

“…Typically, allograft RCC after transplant is diagnosed 5–15 years following transplantation. Although DNA analysis was not conducted in our case, the early appearance of the malignancy suggests the possibility of it being donor-derived RCC, which is supported by the results of a significant retrospective study that observed that de novo malignancies tend to occur beyond 2 years after transplant, and those found in the earlier stages following transplantation are more likely to be donor-derived [ 7 ].…”

An oncogenic role of lncRNA SNHG1 promotes ATG7 expression and autophagy involving tumor progression and sunitinib resistance of Renal Cell Carcinoma

“…RCC is a highly aggressive cancer with unremarkable initial symptoms [ 23 ]. Nearly 30% of RCC patients have developed metastasis at the time of first diagnosis [ 24 ].…”