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EPV244/#93 Malignancies in transplant patients: an atypical presentation and course of ovarian carcinoma – a case report
  1. J Verhaegen1,
  2. XB Trinh2,
  3. B Bracke2,
  4. V Hartman3,
  5. E Philipse4,
  6. G Broeckx5,
  7. K Storm6 and
  8. I Vermeiren7
  1. 1UZA, Gynaecology and Obstetrics, Edegem, Belgium
  2. 2UZA, Gynaecological Oncology, Edegem, Belgium
  3. 3UZA, Hepatobiliary Surgery, Edegem, Belgium
  4. 4UZA, Nephrology, Edegem, Belgium
  5. 5UZA, Pathology, Edegem, Belgium
  6. 6UZA, Genetics, Edegem, Belgium
  7. 7University of Antwerp, Gynaecological Oncology, Edegem, Belgium


Objectives Donor-transmitted malignancies are rare due to the strict selection criteria for donors. Diagnosis is challenging because they often have an atypical presentation and a poor response to treatment.

Methods We present the case of a woman who was diagnosed with a donor-transmitted carcinoma after kidney transplantation.

Results Two years after kidney transplantation, a 61-year-old woman was diagnosed with a FIGO stage IIIB Mullerian ovarian cancer. Treatment with neo-adjuvant chemotherapy was started and complicated due to the use of immunosuppressants. An interval-debulking procedure showed poor response to chemotherapy and an optimal debulking could not be achieved. Pathology revealed a high grade tumor with immunohistochemistry suggestive for lung carcinoma. However, a PET-CT did not indicate any pulmonary disease. Due to the atypical presentation, immunohistochemistry results and untraceable primary tumor additional genetic DNA profiling was performed to further investigate the origin. A Y-chromosome specific marker revealed that the tumor originated from the donor-transplant. The oncological treatment and immunosuppressants were discontinued. The kidney transplant was surgically removed and hemodialysis was initiated. The body’s own immune response led to a clinical, biochemical and radiological complete response and patient has no evidence of disease after 1 year of follow-up.

Conclusions This case report illustrates the diagnostic and therapeutic challenges of cancer in transplant-patients. We suggest that DNA profiling should be standard procedure in transplant patients presenting with metastatic disease. Although donor-transmitted malignancies are a very rare finding, awareness is critical since it can have life-saving clinical implications.

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