Case report: Thyroid carcinoma after kidney tranaplant (1968)

Status: 
Ready to upload
Record number: 
1564
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for thyroid cancer (Council of Europe, 2022): Solitary papillary thyroid carcinoma < 0.5 cm is considered minimal risk and 0.5-2 cm is considered low to intermediate risk. Minimally invasive follicular carcinoma < 1 cm is considered minimal risk and 1-2 cm is considered low to intermediate risk. Newly diagnosed medullary and anaplastic thyroid cancers are an unacceptable risk for organ donation. Thyroid cancer in the donor history: Treated, small, differentiated thyroid cancers (papillary and follicular) are acceptable, analogous to the above recommendations for newly diagnosed thyroid cancers. Curative therapy and adequate follow-up are assumed. No recommendations exist for medullary and anaplastic thyroid cancer but, because of their aggressive clinical behaviour, they should be accepted for organ donation, if at all, only with the highest caution and after a long-term recurrence-free follow-up.
Time to detection: 
0 days
Alerting signals, symptoms, evidence of occurrence: 
Post-donation donor autopsy showed widespread metastatic thyroid carcinoma and review of kidney biopsies showed tumor cells in both kidneys. Recipient asymptomatic but allograft nephrectomy performed on day 7 in light of donor autopsy findings. Carcinoma cells also found in urinary sediment of recipient around this time.
Demonstration of imputability or root cause: 
Demonstration of tumor in donor kidney biopsies (apparently found on review at time of donor autopsy).
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
thyroid carcinoma
anaplastic tumor
histopathological examination
known in donor
Suggest references: 
Muiznieks, H.W.; Berg, J.W.; Robertson, W.; Randall, H.T. Suitability of donor kidneys from patients with cancer Surgery 1968; 64 (5) :871 - 7
Note: 
Please remove original keywords and replace with those given here. Thank you.(OK)
Expert comments for publication: 
Historical case (1965). Donor with known high grade metastatic thyroid carcinoma (giant and spindle cell type) diagnosed 4 months prior to donation. Recipient died about 1 year later with no evidence of donor thyroid carcinoma. Author discussion reviewed renal involvement in head and neck cancers. 7.1-9.9% renal involvement in their series of tongue, larynx, pharynx/nose and oral cavity cancers, with 21.2% involvement in case of salivary gland tumors. Note that data are old and likely do not reflect current frequencies.