Large de novo renal cell cancer in renal allograft: Rare case report and review of literature-A case report

Renal cell cancer (RCC) in renal allograft is a rare entity. We report a case of RCC successfully diagnosed in a 42-year-old renal allograft recipient which developed 13 years after engraftment. The patient was initially evaluated using ultrasound for two episodes of hematuria followed by contrast-enhanced CT scan revealing 9.7 cm x 8.6 cm x 6.5 cm heterogeneously enhancing mass at mid-pole with involvement of renal sinus. Allograft nephrectomy was performed. A genetic study with DNA microsatellite analysis showed de novo RCC from donor origin. Seven months after surgery, the patient is alive with no evidence of tumor recurrence and is now planned for a second renal transplant. To the best of our knowledge, this is the largest allograft RCC reported in the Indian scenario.