We report the case of several nodular formations of presumed neoplasic origin in a kidney 17 years earlier.
This is a 46-year-old male who received a kidney transplant from a cadaveric donor 17 years ago due to a terminal renal failure caused by focal and segmental hydatid disease.
Following an immunosuppression regimen with prednisone and cyclosporine.
The patient remained in hemodialysis for one year before transplantation.
During these 17 years he developed a chronic nephropathy of the graft and in the heart of a deterioration of his figures of basal renal function, a urological ultrasound was performed, finding a solid nodular formation of 35 mm in its largest diameter, suggestive of flow.
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An extension study was performed, with a thoracic CT negative for lung metastases and a total body scan in which bone lesions were not detected.
Abdominal CT performed for a better study of the graft nodule showed the presence of two solid, well-defined, 24-mm and 30-mm nodular cortical formations with homogeneous contrast uptake.
Several small nodular lesions are also observed throughout the graft, which, being very small, cannot be determined if they have a cystic or solid pattern.
No lymphadenopathies are observed at another level.
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The finding of two nodular lesions and multiple hypodense lesions of dubious etiology was decided to perform a transplantectomy.
During surgery, multiple tumors scattered over the surface of the renal graft are observed.
The pathology of the piece is reported as Führ grade 1 multifocal papillary renal cell carcinoma grade III renal capsule that matches renal capsule and the surgical edge of four chronic nodular nephropathy forms of multiple and 97 stage renal resection.
The postoperative course was satisfactory without complications arising from the surgery and returning the patient to the hemodialysis program.
She has been followed up for six months without evidence of local recurrence or distant metastases.
