• Yue Song, Jingjing Zheng, Shiying Guo, and Lianhui Fan.
• Department of Urology.
• Medicine (Baltimore). 2021 May 14; 100 (19): e25858.

RationaleAcquired cystic disease-associated renal cell carcinoma (ACKD-RCC) is a unique subtype of renal cell carcinoma (RCC) and is found exclusively in patients with end-stage renal disease. We report a case of intracapsular nephrectomy (ICAN) of renal allograft with ACKD-RCC. To our knowledge, this is the first case in Asia of ICAN of renal allograft to treat ACKD-RCC.Patient ConcernsA 51-year-old male patient with a history of allogeneic kidney transplantation (23 years previously) presented with renal cystic degeneration of the transplanted kidney over the past 2 years.DiagnosesICAN was used to remove the cystic kidney.InterventionsThe pathology report indicated clear cell renal cell carcinoma.OutcomesTwo years after surgery, computed tomography showed no tumor recurrence, and the patient's creatinine level was 3.5 mg/dl under hemodialysis.LessonsRemoval of transplanted kidney with ACKD-RCC using ICAN is feasible to provide a mid-term tumor-free survival for the patient. Therefore, we consider nephrectomy as an early treatment for the nonfunctional cystic allograft kidney, in order to reduce the dosage of anti-rejection drugs, avoid the occurrence of transplanted kidney tumor, and provide the possibility for the patient an opportunity to receive a second kidney transplantation.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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