An intracapsular nephrectomy for the acquired cystic disease-associated renal cell carcinoma in renal transplant allograft: A clinical case report

RATIONALE: Acquired cystic disease-associated renal cell carcinoma (ACKD-RCC) is a unique subtype of renal cell carcinoma (RCC) and is found exclusively in patients with end-stage renal disease. We report a case of intracapsular nephrectomy (ICAN) of renal allograft with ACKD-RCC. To our knowledge, this is the first case in Asia of ICAN of renal allograft to treat ACKD-RCC. PATIENT CONCERNS: A 51-year-old male patient with a history of allogeneic kidney transplantation (23 years previously) presented with renal cystic degeneration of the transplanted kidney over the past 2 years. DIAGNOSES: ICAN was used to remove the cystic kidney. INTERVENTIONS: The pathology report indicated clear cell renal cell carcinoma. OUTCOMES: Two years after surgery, computed tomography showed no tumor recurrence, and the patient's creatinine level was 3.5 mg/dl under hemodialysis. LESSONS: Removal of transplanted kidney with ACKD-RCC using ICAN is feasible to provide a mid-term tumor-free survival for the patient. Therefore, we consider nephrectomy as an early treatment for the nonfunctional cystic allograft kidney, in order to reduce the dosage of anti-rejection drugs, avoid the occurrence of transplanted kidney tumor, and provide the possibility for the patient an opportunity to receive a second kidney transplantation.