Abstract
BackgroundRenal transplant recipients have increased risk for developing malignant diseases because of immunosuppression or donor-to-recipient transmission. Malignant rhabdoid tumor (MRT) is a rare, highly aggressive and lethal tumor primarily affecting the kidney of infants and young children. MRT has not been reported in the renal allograft of an adult recipient after kidney transplantation.Case presentationIn this report, a 47-year-old woman who received a kidney transplantation from an infant donor and developed a mass in the transplanted kidney is presented. Pathological examinations revealed a malignant tumor with rhabdoid cells morphologically and the loss of INI1 expression immunohistochemically. The diagnosis of malignant rhabdoid tumor in the transplanted kidney was made. We confirmed that donor-to-recipient malignancy transmission was the cause of MRT in the transplanted kidney by fluorescence in situ hybridization (FISH) and short tandem repeat (STR) analysis.ConclusionTo our knowledge, this is the first case of MRT in an adult renal allograft recipient. This report highlights the importance of the criteria for selection of donors to screen possible malignant tumors transmission.
Highlights
Renal transplant recipients have increased risk for developing malignant diseases because of immunosuppression or donor-to-recipient transmission
This report highlights the importance of the criteria for selection of donors to screen possible malignant tumors transmission
Post-transplant lymphoproliferative disorder, the most common post-transplant malignancy, could come from malignant change of passenger leukocytes in the transplanted organ. We favor the former explanation in this case, as it was likely that the tumor cells from Atypical teratoid/rhabdoid tumor (AT/RT) in the central nerve system (CNS) of the pediatric donor metastasized to the kidney, which was transplanted to the adult female recipient
Summary
We report a unique case of MRT in an adult renal allograft recipient after kidney transplantation with characteristic histologic features and loss of INI1 expression. This report highlights the importance of the criteria for selection of donors to screen possible malignant tumors transmission in living and dead donor transplants. Abbreviations AT/RT: Atypical teratoid/rhabdoid tumor; CAIX: Carbonic anhydrase IX; CEP X: X centromere; CEP Y: Y centromere; CgA: Chromogranin A; CNS: Central nervous system; CT: Computed tomography; EMA: Epithelial membrane antigen; FISH: Fluorescence in situ hybridization; GATA-3: GATA binding protein 3; H&E: Hematoxylin & eosin; INI1: Integrase interactor 1; MPNST: Malignant peripheral nerve sheath tumor; MRT: Malignant rhabdoid tumor; MyoD1: Myogenic differentiation 1; SMARCB1: SWI/SNF-related matrixassociated actin-dependent regulator of chromatin subfamily B member 1; STR: Short tandem repeat; Syn: Synaptophysin; TFE3: Transcription factor binding to IGHM enhancer 3
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