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Ian Zheng [1] and Mahmoud Alameddine [1] and Yaohong Tan [2] and Zhobin Moghadamyeghaneh [1; 3] and Joshua S. Jue [1] and Ali Yusufali [1] and Ahmed Farag [1; 4] and Gaetano Ciancio [1]
Academic Editor: Mahmoud Sadeghi
1, Department of Surgery, Division of Transplantation, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA, miami.edu
2, Department of Pathology, University of Miami Miller School of Medicine, Miami, FL 33136, USA, miami.edu
3, Department of Surgery, University of California, San Francisco, CA 94143, USA, ucsf.edu
4, Department of Surgery, Zagazig University School of Medicine, Zagazig, Egypt, zu.edu.eg
Received Feb 18, 2017; Revised Aug 2, 2017; Accepted Aug 7, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Renal cell carcinoma (RCC) accounts for 2% to 3% of all adult malignancies [1]. The most common type of RCC is a clear cell, followed by papillary and chromophobe [2]. Collecting Duct Carcinoma (CDC) is a rare form of RCC that arises from the epithelium of Bellini ducts, located in the distal collecting duct of the renal medulla. It comprises about 1% of all RCC cases [3] and presents earlier in life and at a more advanced stage. CDC behaves more aggressively and is often unresponsive to conventional therapies [4]. Due to its rarity, definitive treatment for advanced and/or metastatic CDC has not been established.
In kidney transplant recipients, the estimated incidence of RCC is fivefold higher than in the general population [5]. An immunosuppressed status, deficient immune surveillance of malignant cells [6, 7], and reduced protection against oncogenic viruses [8, 9] may all contribute to the increased risk of cancer in transplant patients. The RCC subtypes of postrenal transplant patients include clear-cell carcinomas, chromophobe, and papillary carcinomas [10, 11]; however, CDC has not been previously reported in this setting.
The goal of this study is to report a novel case of postrenal transplant CDC in the native kidney that was complicated by distant metastases and to improve understanding of clinical and pathological characteristics. Treatment options for this disease in transplant patients will also be discussed.
2. Case Report