BACKGROUND: The risk of donor-transmitted cancer is evident.

CASE REPORT: We report the case of a 69-year-old woman who was transplanted with a kidney from a deceased donor. Four days after transplantation a routine ultrasound scan revealed a 3-cm tumor in the middle-upper pole of the allograft. A biopsy showed the tumor to be papillary renal cell carcinoma. The patient was treated with radiofrequency ablation. This procedure was complicated by the development of a cutaneous fistula and open surgery was done with resection of an area of necrosis in the kidney and of the fistula. The maintenance immunosuppressive regimen was modified with a change in treatment to everolimus in combination with reduced dose mycophenolate and low-dose steroids. The patient was followed for 4.5 years and during that time she remained dialysis independent with an excellent allograft function (serum creatinine, 95 μmol/L [1.04 mg/dL]).

CONCLUSIONS: To the best of our knowledge, this is the first case in which a donor-transmitted tumor was diagnosed in the renal allograft only 4 days after transplantation and subsequently treated successfully with radiofrequency ablation.