Bilateral Native Kidney Papillary Renal Cell Carcinomas in a 11-Year-Old Renal Transplant Patient.

Pub Date : 2022-01-01 DOI:10.1055/s-0042-1759546
Çiğdem Ulukaya Durakbaşa, Deniz Ugurlu, Sabriye Gulcin Bozbeyoglu, Sinem Aydoner, Hatice Seneldir, Mehmet Onur Candir, Cengiz Candan, Atilla Gemici
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Abstract

Renal cell carcinomas (RCCs) are the most common renal tumors in adults and are usually sporadic and unilateral. Renal transplant recipients have an increased risk of developing RCC. RCC development after kidney transplantation is very rarely reported in children. We present a 11-year-old boy who had cadaveric kidney transplantation for kidney failure 2 years ago. He was under immunosuppressive therapy and presented with microscopic hematuria. An ultrasound (US) revealed bilateral solid renal masses. Further cross-sectional imaging showed a 60 × 70 × 60-mm right renal mass with claw sign and a 5 × 6 × 6-mm mass in the left renal lower pole. A bilateral radical nephroureterectomy of native kidneys was performed. The pathology revealed bilateral papillary RCC without TFE3 upregulation. The patient was kept on low-dose immunosuppressive therapy in the perioperative period. He received no chemotherapy but a close radiological surveillance was undertaken. He is tumor-free 2 years after the operation. RCC is a rare tumor for children and bilateralism is even rarer. The child had a history of chronic kidney disease, peritoneal dialysis, and immunosuppressive therapy. As there are no standardized protocols regarding imaging in transplanted kidneys routine surveillance, US follow-up should also focus on detecting malignancy.

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11岁儿童肾移植患者双侧原生肾乳头状肾细胞癌。
肾细胞癌(RCCs)是成人最常见的肾脏肿瘤,通常是散发的和单侧的。肾移植受者发生肾细胞癌的风险增加。儿童肾移植后肾细胞癌的发展很少有报道。我们报告了一个11岁的男孩,他在2年前因肾衰竭而接受了尸体肾移植。他正在接受免疫抑制治疗,显微镜下出现血尿。超声显示双侧肾实性肿块。进一步横断面成像显示右肾60 × 70 × 60 mm肿块伴爪征,左肾下极5 × 6 × 6 mm肿块。行双侧原生肾根治性肾输尿管切除术。病理显示双侧乳头状肾细胞癌无TFE3上调。围手术期给予低剂量免疫抑制治疗。他没有接受化疗,但进行了密切的放射监测。手术后2年肿瘤消失。肾细胞癌是一种罕见的儿童肿瘤,而双侧肿瘤更是罕见。该患儿有慢性肾脏疾病、腹膜透析和免疫抑制治疗史。由于在移植肾常规监测中没有标准化的成像方案,美国随访也应侧重于发现恶性肿瘤。
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