Gigantomastia and breast lumps in a kidney transplant recipient

KIDNEY transplantation (Tx) is the treatment of choice for chronic renal failure. A successful graft permits recovery of renal function and a good quality of life, both being seriously compromised by the disease and the haemodialytic therapy. From the first hours after the operation, patients must receive several drugs to prevent rejection and infections, many immunosuppressive regimens are adopted worldwide. The most commonly used is the triple therapy with cyclosporine A (CyA), prednisolone (P), and azathioprine (A). The former two drugs are demonstrated to interfere with the neuroendocrine system, being able to alter the function of different organs and to modify hormone blood levels. Kidney graft recipients are prone to develop high arterial blood pressure (ABP); and despite advances in patient management, the prevalence of posttransplant hypertension (HT) is about 50%. As HT is known to deteriorate renal function, ABP should be kept in the normal range values. Calcium antagonists (CA) are preferred to regulate ABP. Unfortunately, they also somehow interfere with the neuroendocrine system. In this paper, we describe the case of a woman who, a few years after undergoing a cadaver kidney transplant, developed gigantomastia in association with two lumps.