JILTI. 2024; 2(3): 131-134 | DOI: 10.14744/jilti.2025.69188

Primary Kidney Lymphoma Mimics Renal Cell Carcinoma in Preoperative Liver Transplant Patient: Postoperative Challenge – A Case Report

Oguzhan Sal¹, Altan Alim², İsmail Tirnova³, Sezan Vehbi², Baris Demir², Turan Kanmaz^2
1Department of General Surgery, Istanbul University, Faculty of Medicine, Istanbul, Türkiye
²Koç University, Faculty of Medicine, Liver Transplantation Center, Istanbul, Türkiye
³Department of General Surgery, Başkent University, Faculty of Medicine, Istanbul, Türkiye

Cancer screening is a critical component of the pretransplantation process. However, in patients with deteriorating liver function, the focus may shift towards acquiring a functioning liver, potentially delaying cancer evaluation.
A 42-year-old male with primary sclerosing cholangitis (PSC), CTP score C10, and MELD score 19 was evaluated for liver transplantation (LT). Preoperative imaging revealed two lesions in the upper pole of the left kidney, raising concern for malignancy. After discussion at a uro-oncology meeting, the decision was made to resect the lesions post-LT. On postoperative day 5, the patient underwent entero-enterostomy revision and resection of the renal lesions due to melena. Pathological analysis confirmed Burkitt lymphoma/high-grade B-cell lymphoma-NOS. The patient completed four cycles of chemotherapy and remained free of recurrence by the second postoperative year.
This case underscores the importance of cancer screening in LT candidates and highlights the need for biopsy when radiologic suspicion arises. Management should be individualized, considering both liver disease severity and malignancy, with a tailored treatment approach.

Keywords: Post-transplantation lymphoproliferative disease, Ebstein-Barr Virus (EBV), Burkitt Lymphoma, Liver transplantation

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