BK virus-associated urothelial carcinoma of a ureter graft in a renal transplant recipient: a case report.

BACKGROUND: Urothelial carcinomas of ureter grafts in renal transplant patients are rare. Here we report our experience with a case of BK virus-associated urothelial carcinoma in a ureter graft. CASE REPORT: A 47-year-old man developed chronic renal failure secondary to diabetes mellitus and started maintenance hemodialysis in September 2007. Two months later, the patient received a renal transplant from his 70-year-old mother. The patient developed BK virus-associated nephropathy 1 year after transplantation and presented with a decline in renal function and hydronephrosis in the transplanted kidney 4 years 6 months after transplantation. Cystoscopy and retrograde pyelography revealed an irregular filling defect in the ureter graft. Cytologic diagnosis of his urine revealed a high-grade urothelial carcinoma. Computerized tomography showed a cT2 ureteral tumor and no involvement of other organs. The patient subsequently underwent a transplant nephroureterectomy with bladder cuff resection. Histopathologic findings revealed a high-grade urothelial carcinoma, pT2, in the ureter graft with SV40-positive staining. The patient was closely observed without adjuvant chemotherapy therapy and remained disease free 1 year after surgery. Renal transplant recipients with BK virus infection are at high risk of developing urologic malignancies. Close attention is necessary to diagnose post-transplantation urologica malignancies as early as possible.

Renal cell carcinoma detected by preoperative kidney transplant donor examination: a case report.

A 37-year-old man undertook preoperative examination for donor nephrectomy for living kidney transplantation. Computerized tomography revealed a small renal mass (1.9 cm in diameter) with contrast enhancement on his left kidney. We couldn't exclude malignant potential for the small mass. Laparoscopic left partial nephrectomy without renal artery clamp was successfully carried out to obtain pathologic diagnosis while preserving his renal function and priority as a donor. He was judged to be an inappropriate donor candidate owing to the histopathologic report suggesting clear cell carcinoma. The patient has been followed for 27 months without any evidence of recurrence.