Partial nephrectomy used to treat renal cell carcinoma arising in a live donor transplant kidney

There are few reported cases of renal cell carcinoma (RCC) arising in kidney allografts. Whether these tumours occur due to post-transplant malignant transformation or are present at the time of transplantation is unclear. The influence of immunosuppression must be considered in their development, progression and treatment. We report a case of a RCC presenting asymptomatically in a functioning live donor renal allograft 173 months after transplantation. In an attempt to avoid return to dialysis treatment, a partial nephrectomy was carried out. To optimise the procedure, and to assure cancer clearance, combined intraoperative ultrasound and frozen section analysis were used. Our patient remains disease free and dialysis independent at 22 months follow up. To our knowledge, this patient represents the only live donor organ transplant tumour reported to be treated using nephron-sparing surgery and remain dialysis independent. Partial nephrectomy should be considered as a treatment option in such cases.