Papillary renal cell carcinoma in allograft kidney

Abstract

Papillary renal cell carcinoma is a subgroup of malignant renal epithelial neoplasms. Its occurrence in allograft transplanted kidney has not been debated in the literature. We report two pathologically proven cases and discuss the clinical hypothesis for such neoplasms and the aspect on MR images. The paramagnetic effect of the iron associated with an absence of signal coming from calcifications is a plausible explanation for this unusual hypo-intense appearance on T2-weighted sequence.

MR Imaging of papillary renal neoplasms: potential application for characterization of small renal masses

“…In our study, most of the subtype I P RCCs exhibited a hypointense homogeneous pattern. This markedly observed low signal intensity on T2-weighted imaging is attributed to the paramagnetic effect of the abundant hemosiderin deposition within the tumors cells [23,24]. The presence of iron in RCC secondary to hemorrhage is not uncommon, but it is not necessarily related to hemorrhage, but to reactive changes in the lymphoreticular system.…”

De novo Renal Cell Carcinoma in a Kidney Allograft 13 Years after Transplantation: A Case Report and Review of the Literature

“…Single, localized tumors, less than 3-4 cm, peripherally located can be treated by polar nephrectomy, wedge resection or enucleation, in cases of tumors well-demarcated from the parenchyma. Recently, percutaneous cryoablation and radiofrequency ablation have been introduced and described in single case reports [5,10] . In any case, the pros and cons of nephron-sparing methods of treatment of RCC of the kidney graft should be explained to the patient and the patient's wishes taken into account.…”

“…The most common presentation of RCC of the kidney graft is a vague abdominal discomfort or fever with or without proteinuria, hematuria or leukocyturia [2][3][4][5] . The interval between transplantation and tumor detection ranges between 2 and 258 months (mean 56), though it is arguable whether carcinomas developing within the fi rst 2 years represent de novo tumors or they were already present in the allograft at the time of harvesting [1,6] .…”

“…On the other hand, partial nephrectomy can be attempted if tumor size, location and blood supply are favorable [5,6,9] . Single, localized tumors, less than 3-4 cm, peripherally located can be treated by polar nephrectomy, wedge resection or enucleation, in cases of tumors well-demarcated from the parenchyma.…”

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

“…Roupret evaluated a renal clear cell cancer (RCC) cumulative incidence of 0.24% among RTR population [3]. Most of these malignancies are RCC but papillary types 1 and 2, tubulopapillary, chromophobic, sarcomatoid, epidermoid and urothelial carcinomas and oncocytomas have been described [4][5][6][7][8]. http Kidney graft tumors represent a particular therapeutic dilemma.…”