# Primary Squamous Cell Carcinoma in a Transplanted Kidney: A Unique Case Highlighting Challenges in Diagnosis and Management

## TL;DR

A rare case of primary squamous cell carcinoma in a transplanted kidney is reported, highlighting diagnostic and management challenges in transplant recipients.

## Contribution

This is the first reported case of primary renal squamous cell carcinoma in an allograft kidney.

## Key findings

- A patient with a one-year-old kidney transplant was diagnosed with primary squamous cell carcinoma.
- The case underscores the need for improved cancer surveillance in transplant recipients.
- Combining imaging with serum and urine studies may enhance cancer detection in allografts.

## Abstract

Kidney transplantation is the preferred treatment for end-stage renal disease, but it involves risks, including an increased chance of malignancy due to several variables. We present a rare case of primary renal squamous cell carcinoma (SCC) in an allograft kidney. This patient, who had a renal transplant one year prior, presented with oliguria, elevated creatinine, and asthenia. Imaging done raised suspicion of a mass-like structure and biopsy subsequently done confirmed a primary SCC in the transplanted kidney, leading to a total nephrectomy and hemodialysis initiation. This case highlights the different cancer risks faced by transplant recipients, particularly due to immunosuppressive medications. We discuss emerging alternatives in immunosuppression that may mitigate these risks. Given the rarity of primary SCC in allografts, determining the cancer’s origin whether primary or metastatic is critical for effective management since this distinction could shape future approaches to managing allograft malignancies. We also emphasize the importance of establishing imaging and monitoring guidelines and how combining imaging with serum and urine studies may enhance cancer surveillance, aiding in long-term graft health and transplant longevity.