Fatal progression of squamous cell carcinoma 10 years after cadaveric kidney transplantation

Various research has shown that non-melanocytic malignant skin lesion is one of the most common post-kidney transplant neoplasms. Multiple lesions and a more aggressive clinical course are more common in kidney transplant patients than in the general population. This paper presents a case of malignant skin neoplasms in a patient 10 years after cadaveric kidney transplantation. The patient received standard 3-component immunosuppression with satisfactory graft function (serum creatinine level remained at 157–178 μmol/L). Scalp neoplasm was removed. Histological examination revealed a morphological picture characteristic of basal cell carcinoma with squamous differentiation. Subsequently, a relapse of the skin neoplasm of the temporal region, as well as new lesions in the frontal region and the skin of the anterior chest wall, were discovered. Despite surgical treatment and close-focus x-ray radiation, the disease rapidly progressed and eventually led to death. Squamous cell carcinoma can progress very rapidly in patients after solid organ transplantation, despite ongoing combination treatment. Perhaps in such cases, it is worth cancelling immunosuppressive therapy completely and removing the kidney graft in order to control progression of the malignant tumor process.

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Primary Adenocarcinoma of Cutaneous Vesicostomy 40 Years Later: A Rare Case

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-e58-paocvy ◽

2004 ◽

Vol 128 (4) ◽

pp. e58-e59 ◽

Cited By ~ 1

Author(s):

Paulos Yohannes ◽

William Hunter ◽

Malini Prasad

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Kidney Transplant ◽

Squamous Cell ◽

Rare Case ◽

Primary Adenocarcinoma ◽

Cadaveric Kidney ◽

Cutaneous Vesicostomy

Abstract We present a case of adenocarcinoma developing at the vesicocutaneous edge of a vesicostomy, 40 years after it was created, in a patient who underwent cadaveric kidney transplant. Although transitional and squamous cell carcinoma of a vesicostomy have been reported, to our knowledge, the presence of adenocarcinoma at the vesicostomy edge has not been reported previously.

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Safe Administration of Cemiplimab to a Kidney Transplant Patient with Locally Advanced Squamous Cell Carcinoma of the Scalp

Current Oncology ◽

10.3390/curroncol28010057 ◽

2021 ◽

Vol 28 (1) ◽

pp. 574-580

Author(s):

Luca Paoluzzi ◽

Thomas J Ow

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Kidney Transplant ◽

Squamous Cell ◽

Locally Advanced ◽

Kidney Transplant Patient ◽

Cell Transplant ◽

Renal Transplant Recipients ◽

Advanced Squamous Cell Carcinoma ◽

Hematopoietic Stem

Immunotherapies directed at T-cell activation through antibodies targeting checkpoint proteins, such as programmed cell death 1 (PD1), are rapidly becoming the new standard of care in the treatment of several malignancies. Cemiplimab is a monoclonal antibody targeting PD1 that has recently emerged as a highly active treatment for locally advanced and metastatic cutaneous squamous cell carcinoma (CSCC). Patients who have received an organ transplant (OTRs) have been traditionally excluded from clinical trials with checkpoint inhibitors (CIs), given concerns for organ rejection. Renal transplant recipients (RTRs) are more likely to develop cancers than the general population, and skin cancers are among the most frequent malignancies. We report the case of a 72-year-old man with a history of a kidney transplant who presented with a rapidly growing, locally advanced squamous cell carcinoma (SCC) of the scalp that recurred within four weeks from surgical resection. The patient was able to safely receive ten cycles of cemiplimab so far with significant clinical benefit, and no issues with his kidney function, while continuing immunosuppression with low dose prednisone alone. An ongoing clinical trial (NCT04339062) is further exploring the safety of CIs in patients with metastatic CSCC who have previously received allogeneic hematopoietic stem cell transplant or a kidney transplant.

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