Dramatic recurrence of cancer in a patient who underwent kidney transplant – an analysis of post-transplant cancer recurrence and case report
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 2
Abstract
Beside cardiovascular diseases and infections, cancers are the main cause of death in patients after transplantation of a vascularised organ. After transplantation, usually de novo cancers develop. Recurrence of cancers which had been diagnosed and treated before transplantation is much rarer. In exceptional cases, cancer is transferred with the donor’s organ. The epidemiology and the course of post-transplant de novo neoplasia is relatively well known. However, the issue of recurrence of pre-transplant cancer, which is significantly rarer and its course more individualised and difficult to predict, poses a challenge to contemporary transplantation.This paper presents an unexpectedly rapid recurrence of rare cancer – endometrial stromal sarcoma – which occurred shortly after transplantation of a kidney from a deceased donor to a patient who had undergone cancer treatment 7 years earlier. The dramatic course of the disease, complicated with recurrent massive thrombosis of the inferior vena cava and the right cardiac cavities as well as pulmonary embolism and serious infectious complications illustrate the difficulties related to qualifying patients with a history of malignancy for transplantation. The scale of the problem will most likely increase as older recipients are being put on transplant waiting lists and cancer treatment is becoming more effective.The authors of this paper, based on the case report presented and the review of literature, attempt to find an answer to the question about the risk of cancer recurrence in patients receiving immunosuppressive therapy and find out how it can be minimized. Answering these questions is particularly important if the recurrent cancer is substantially more aggressive, cancer treatment options are limited and the prognosis is poor due to lack of immunocompetence.
Authors and Affiliations
Renata Wieczorek-Godlewska, Magdalena Durlik
Keywords
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