%0 Journal Article
%T Late pulmonary metastases of renal cell carcinoma immediately after post-transplantation immunosuppressive treatment: a case report
%A Jose Cozar
%A Natalia Aptsiauri
%A Miguel Tallada
%A Federico Garrido
%A Francisco Ruiz-Cabello
%J Journal of Medical Case Reports
%D 2008
%I BioMed Central
%R 10.1186/1752-1947-2-111
%X In 1986 the patient demonstrated renal insufficiency secondary to mesangial glomerulonephritis. In 1992 he underwent left side radical nephrectomy with histopathological diagnosis of clear cell adenocarcinoma. Mesangial glomerulonephritis in the remaining right kidney progressed to end-stage renal failure. In October 2000 he received a kidney transplant from a cadaver and commenced immunosuppressive medication. Two months later, several nodules were found in his lungs, which were identified as metastases from the primary renal tumor that had been removed with the diseased kidney 8 years earlier.Recurrence of renal cell carcinoma metastases points to tumor dormancy and reflects a misbalance between effective tumor immune surveillance and immune escape. This case demonstrates that a state of tumor dormancy can be interrupted soon after administration of immunosuppressant medication.Renal cell carcinoma (RCC) is the most common renal malignancy [1]. Late recurrence of metastatic renal carcinoma has previously been described [2-5]. The greatest risk of recurrence for RCC occurs within the first 5 years after nephrectomy [6]. Although, recurrences have been reported as late as 30 years following nephrectomy, rates of 43% in the first year, 70% within the second year, 80% within 3 years, and 93% within 5 years have been reported [7,8]. After nephrectomy, the incidence of RCC recurrence has been reported to be 7% with a median time of 38 months for T1 tumors, 26% with a median time of 32 months for T2 disease, and 39% with a median time to recurrence of 17 months for T3 tumors [9]. RCC has been shown to metastasize to almost all soft tissues in the body, but most commonly to the lung, followed by bone, liver, brain, and local recurrence [10]. RCC metastases occur frequently in the lung, affecting 3% to 16% of patients after nephrectomy [8,9,11].It is well known that patients who have undergone solid organ transplantation and are taking immune suppressing drugs to prevent o
%U http://www.jmedicalcasereports.com/content/2/1/111