Molecularly Confirmed Female Donor-Transmitted Lobular Breast Cancer to Male following Renal Transplantation

Abstract

<b><i>Introduction:</i></b> Lobular breast cancer represents 10%–15% of breast cancers in women but is virtually nonexistent in men, related to the typical absence of the anatomic breast lobule structure in male breast tissue. We describe donor-transmitted metastatic lobular carcinoma to a male after kidney transplantation. Determining whether a post-transplant cancer is transplant associated, donor transmitted, or donor derived is significant for treatment, prognosis, and possibly management of other organ recipients. <b><i>Case Report:</i></b> A 74-year-old Caucasian male presented to the emergency department with lower abdominal pain and macro-hematuria. Past medical history included two renal transplantations. Computed tomography identified a 4–5-cm space-occupying lesion in the native left kidney. A left native nephrectomy was performed. Histology pathologic examination demonstrated lobular (as opposed to ductal) breast carcinoma. Fluorescent in situ hybridization probes to identify X- and Y-chromosomes showed tumor cells with an XX genotype, whereas the surrounding host cells were of XY genotype. These findings confirmed the female-sex origin (donor) of the tumor within the XY native male (current patient) tissues. <b><i>Discussion/Conclusion:</i></b> Due to discordance between the donor and recipient sex, fluorescent in situ hybridization as a molecular technique correctly identified the origin of an individual’s cancer in the post-transplant setting. The metastatic breast cancer behaved more indolently than usually seen. Expanded criteria donors (ECD) are those who cannot donate under standard criteria for organ transplantation; expanded criteria widen the potential organ donor pool at the expense of increased risk for post-transplant complications (e.g., graft failure, the transmission of malignancy). The case provides a potential area of future research into considering allowing ECDs with a distant history of cancer with very low transmission risk when the biochemical environment of the recipient would, in the unlikely event of transmission, induce the tumor to pursue an indolent clinical course.

RETRACTED: Meta analysis of clinical prognosis of radiofrequency ablation versus partial nephrectomy in the treatment of early renal cell carcinoma

“…Radio frequency therapeutic instrument generates high-frequency electromagnetic wave (480HZ) through tumor generator, which acts on surrounding tissue cells to produce high-speed ion vibration and friction. When the temperature can reach above 6 °C, the protein denatures, and the tumor tissue undergoes coagulation necrosis and evolution ( 23 , 24 ). It is a liquefaction foci or fibrous tissue ( 23 ).…”

Idiopathic fibroadenoma in an elderly man

“…Typically, fibroadenomas occur in women younger than 30 years of age. In men, fibroadenomas are particularly rare since the anatomic breast lobule structure is rarely present and the lobular structure acts as the main site for fibroadenoma development 3 4. Here, we present an elderly man with a left breast fibroadenoma alongside a history of ischaemic heart disease and associated severe complications.…”