Painful angiomyxoid tumor in a failed renal allograft presenting as post-transplant lymphoproliferative disorder

Introduction: There exist few reports of de novo tumors involving an allograft kidney, and to the best of our knowledge there are only two previous reports of angiomyxoma Case Presentation: A 53-year-old Caucasian male with end-stage renal disease (ESRD) on hemodialysis (HD) secondary to malakoplakia with three failed prior renal transplants presented for repeat transplant evaluation. Imaging demonstrated a mass of the transplanted kidney suggestive of posttransplant lymphoproliferative disease (PTLPD). A biopsy was obtained revealing a predominance of myxoid material. The patient became increasingly symptomatic from the mass and underwent a palliative right transplant nephrectomy. Final pathology revealed angiomyxoid tumor. Conclusions: Angiomyxomas are asymptomatic, appear as PTLD on imaging and should be considered in the differential diagnosis of masses occurring in renal transplant allografts.