BK virus-associated collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft recipient

// Myriam Dao 1, 2 , Adrien Pecriaux 1 , Thomas Bessede 2, 3 , Antoine Durrbach 2, 4 , Charlotte Mussini 1 , Catherine Guettier 1, 2 and Sophie Ferlicot 1, 2 1 Pathology Department, CHU Bicetre, Le Kremlin-Bicetre, France 2 University Paris-Sud, Le Kremlin-Bicetre, France 3 Urology Department, CHU Bicetre, Le Kremlin-Bicetre, France 4 Nephrology Department, CHU Bicetre, Le Kremlin-Bicetre, France Correspondence to: Myriam Dao, email: myriam.dao@aphp.fr Keywords: collecting duct carcinoma; renal allograft carcinoma; kidney transplantation; BK polyomavirus; SV40 Received: November 06, 2017      Accepted: February 10, 2018      Epub: February 22, 2018      Published: March 13, 2018 ABSTRACT BK polyomavirus (BKV) nephropathy is a major concern in renal transplantation. Its main consequence is graft loss, which occurs in more than 50% of the cases. De novo renal cell carcinoma in renal allograft is a very rare event. Most of these tumors are papillary or clear cell carcinomas. We report herein the first case of collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft adult recipient. Collecting duct carcinoma occurs long after the cure of a BKV nephropathy. At this time, BKV viremia and viruria were negative as well as the immunostaining for SV40 in the non-tumor kidney. The viral oncoprotein Tag persists only in the tumor cells. To preserve pancreas graft function, we maintained immunosuppression levels. After a 9-months follow-up, the evolution was free from clinical and radiological progression. The oncogenic role of BKV remains controversial in human cancers. However, strong experimental data have shown an association between BKV infection and urologic neoplasms. Further works might precise the exact role of polyomaviruses in renal carcinogenesis. In the meantime, clinical vigilance for early diagnostic of these tumors is mandatory after BKV nephropathy.