[Renal cell carcinoma: unusual late metastases 14 and 23 years after kidney transplantation]

Abstract

History and findings: An asymptomatic 70-year-old man was found to have a tumor in the region of the left adrenal gland, having undergone cadaveric kidney transplantation 23 years ago. Two years before this a right nephrectomy had been performed for a renal cell carcinoma. There was no left kidney because of agenesis. 14 years after the kidney transplantation a metastasis of the renal cell carcinoma was identified in the thyroid gland. After its resection no further metastases had been discovered.

Investigations: Laboratory tests were unremarkable. But a tumor was detected in the left adrenal gland by computed tomography.

Diagnosis, treatment and course: The left adrenal gland was successfully resected. Its histology confirmed a second metastasis of the renal cell carcinoma 23 years after renal transplantation, but no other metastases were found.

Conclusions: Kidney transplantation can be successfully performed even in patients with pre-existing carcinoma. A late metastasis of a renal carcinoma may occur. Close long-term follow-up of the patients is therefore essential.