Abstract:
Renal transplantation significantly improves survival and quality of life in patients with end-stage renal disease; however, it is associated with an increased risk of malignancy, particularly in native kidneys. The incidence of renal cell carcinoma (RCC) in transplant recipients is reported to be up to 15-fold higher than in the general population, often linked to long-term immunosuppression and acquired cystic kidney disease. We present the case of a 48-year-old male who underwent living donor renal transplantation 10 years prior and was maintained on immunosuppressive therapy. During routine follow-up, computed tomography imaging (page 2) revealed bilateral cystic renal lesions with enhancing solid components, consistent with multifocal renal masses. No distant metastases were identified. The patient underwent bilateral radical nephrectomy with preservation of the functioning graft. Histopathological examination demonstrated bilateral multifocal papillary renal cell carcinoma, Fuhrman grade 1–2, staged as T1aN1M0, with no lymphovascular invasion or sarcomatoid features. Follow-up over 36 months showed no evidence of recurrence or disease progression. This case highlights the increased risk of synchronous bilateral RCC in native kidneys of renal transplant recipients and emphasises the role of acquired cystic kidney disease as a key predisposing factor. Regular surveillance using imaging modalities is essential for early detection. Surgical management remains the mainstay of treatment, with favourable outcomes when diagnosed at an early stage.

Biography:
Dr. Haytham Araibi is a urology specialist with over 13 years of experience in general surgery and urology, with a particular interest in transplant urology, oncology, and minimally invasive surgery. He currently works as a Specialty Doctor in Urology in the United Kingdom and previously served as a Senior Clinical Fellow in Transplant and Renal Surgery at Guy’s Hospital, London. He holds an MD in Urology and master’s degrees in Medical Education and Human Morphology and Anatomy. Dr. Araibi is a member of the Royal College of Surgeons of Ireland and has multiple peer-reviewed publications in urology, including studies on transplant-related malignancies and complex surgical cases.