Advanced native kidney renal cell carcinoma in renal transplant recipients: role of sirolimus as dual anti-cancer and anti-rejection agent

Clin Nephrol. 2013 Feb;79(2):154-60. doi: 10.5414/cn107107.


The incidence of native kidney renal cell carcinoma (RCC) in renal transplant recipients is 15 times higher than the general population. These tumors are often found incidentally when imaging is performed for another indication. At that stage tumors are usually small and asymptomatic but it is possible that they may escape detection until a more advanced stage. Early stage RCC can be treated with radical nephrectomy but the treatment of advanced RCC may be more complicated and is associated with a poorer prognosis. RCC in context of renal transplant presents a special therapeutic challenge; balancing treatment of a potentially lethal malignancy in a redundant organ whilst maintaining good allograft function.We describe 2 cases of advanced renal cell carcinoma of native kidneys in renal transplant recipients and present our experience with sirolimus as a dual immunosuppressive and anti-tumor agent.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / etiology
  • Carcinoma, Renal Cell / surgery
  • Female
  • Graft Rejection / drug therapy
  • Graft Rejection / prevention & control
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / etiology
  • Kidney Neoplasms / surgery
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Radiography
  • Sirolimus / therapeutic use*
  • TOR Serine-Threonine Kinases / antagonists & inhibitors
  • TOR Serine-Threonine Kinases / metabolism


  • Antineoplastic Agents
  • Immunosuppressive Agents
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Sirolimus