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A 52-year-old patient with a personal history of end-stage renal failure of unrelated etiology who received a heterotopic transplant in IDF from a cadaveric donor in January 1999. He had previously required hemodialysis from 1980 to 1983, and peritoneal dialysis from then on until the time of renal transplantation. There were no post-transplant complications. The patient received triple therapy with Cyclosporine, Prednisone and Mycophenolate, with immediate diuresis and progressive improvement in renal function, with creatininemia at discharge of 1.8 mg/dl. After a 51-month non-complicated and asymptomatic post-transplant period in which renal function remained stable (creatinine lower: 1.2-1.4 mg/dl) a solid 1.5 cm nodule of the renal graft was observed in the control ultrasound. The subsequent ultrasound-guided FNA revealed a CRC. 1. In June 2003, after reopening the Gibson incision previous to the RIF, and after the release of the renal graft from the surrounding adhesions, a well circumscribed exophytic tumor of 1.5 cm was identified. Tumorectomy was performed with margin of more than 0.5 cm of macroscopically healthy parenchyma, sending intraoperatively baseline samples that were informed as free of tumor involvement. We performed intraparenchymal stitches of the bleeding vessels and approximation points of "colchoner" supported by Goretex and Surgicel with conservative purposes. 1. Definitive histopathological diagnosis was type I papillary renal carcinoma, Fuhrman grade 2, UICC stage I (pT1a, Nx, Mx) with resection margins and peritumoral fat without tumor involvement. There were no complications in the postoperative course of the tumorectomy, and therapy was not modified. At almost three-year follow-up, initially quarterly and subsequently every six months, by renal function study and ultrasound or MRI there is no evidence of tumor recurrence at present with proteinuria and creatinine clearance of 115.5 mg/ dl. |