BK Polyomavirus-Associated Carcinoma In Situ of the Renal Allograft: Balancing Oncologic Control and Graft Preservation.
Emma Powell, Peter Lawlor, Melvyn Kuan
✦ AI-curated · Sources linked
Case in brief
A female renal transplant recipient in her 60s presented with biopsy-proven carcinoma in situ (CIS) of the urothelium within her renal allograft, following a history of BK polyomavirus nephropathy. Despite no visible lesions on imaging, a kidney-sparing approach using intrarenal gemcitabine and intensive surveillance was initiated. Although initial follow-up showed no progression, a repeat biopsy two years later revealed persistent CIS and ongoing BKPyV replication.
Diagnostic / clinical pearl
Clinicians should be aware that BK polyomavirus can be associated with carcinoma in situ in renal allografts, necessitating careful monitoring and management strategies that prioritize graft preservation.
Why it matters
This case highlights the complexities of managing BKPyV-associated malignancies in transplant recipients, emphasizing the need for tailored approaches that balance oncologic control with the preservation of renal function.