Fatal Melanoma Transferred in a Donated Kidney 16 Years after Melanoma Surgery

Abstract

We report a case of fatal melanoma that had been transferred in a donated kidney and that occurred 16 years after surgery for primary melanoma in the donor. A woman with polycystic disease received a renal transplant in May 1998. The graft functioned well. In November 1999, routine mammography showed a nodule in the left breast, and a biopsy specimen was obtained. Primary breast cancer was diagnosed. Pain and swelling then developed over the renal transplant, and two subcutaneous nodules were found. Biopsy confirmed the presence of secondary melanoma. No primary melanoma was identified. The pathological features of the breast specimen were reviewed, immunocytochemistry was performed, and secondary melanoma was diagnosed. Immunosuppression was stopped, the nodules were excised, and the patient underwent a trial of interferon, which was stopped because of toxicity. She died of metastatic melanoma in March 2000. In May 2000, a man presented with a palpable lump over a kidney, also donated in May 1998. The function of the graft had been good. Renal biopsy showed secondary melanoma, and again no primary tumor was identified.