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作 者:Hui Wang Wen-Li Song Wen-Juan Cai Gang Feng Ying-Xin Fu
机构地区:[1]Department of Kidney and Pancreas Transplant,Tianjin First Central Hospital,School of Medicine,Nankai University,Tianjin 300192,China [2]Department of Pathology,Tianjin First Central Hospital,School of Medicine,Nankai University,Tianjin 300192,China
出 处:《World Journal of Clinical Cases》2021年第17期4365-4372,共8页世界临床病例杂志
基 金:National Natural Science Foundation of,No.81970654.
摘 要:BACKGROUND There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later.In this paper,we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma(ChRCC)involving the allograft kidney.CASE SUMMARY A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal disease.Maintenance immunosuppression consisted of tacrolimus,mycophenolate mofetil(MMF),and prednisone.Six years posttransplantation,at another hospital,ultrasonography revealed a small mass involving the upper pole of the graft.The patient declined further examination and treatment at this point.Seven years and three months post-transplantation,the patient experienced decreasing appetite,weight loss,gross hematuria,fatigue,and oliguria.Laboratory tests showed anemia(hemoglobin level was 53 g/L).Contrast-enhanced computed tomography revealed a large heterogeneous cysticsolid mass involving the upper pole of the renal allograft.Graft nephrectomy was performed and immunosuppressants were withdrawn.Histological and immunohistochemical features of the tumor were consistent with ChRCC.One year after allograft nephrectomy,low doses of tacrolimus and MMF were administered for preventing allosensitization.Two years after allograft nephrectomy,the patient underwent kidney re-transplantation.Graft function remained stable with no ChRCC recurrence in more than 2-years of follow-up.CONCLUSION De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of immunosuppression.Kidney re-transplantation could be a viable treatment.A 2-year malignancy-free period may be sufficient time before re-transplantation.
关 键 词:CHROMOPHOBE Renal cell carcinoma KIDNEY NEPHRECTOMY TRANSPLANTATION Case report
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