Multiple tumors in a renal transplant recipient.

The case of a 54-year-old man who developed multiple epithelial tumors during his sixth year post-renal transplantation is reported. The tumors included keratoacanthomas of the forehead and neck, squamous carcinoma of the forehead, basal cell carcinoma of the cheek, multiple colonic adenomatous polyps and multiple ileal carcinoids. In addition, he had marked parathyroid hyperplasia in spite of good renal function, and pancreatic islet cell hyperplasia. Although there is a 5-6% incidence of de novo malignant neoplasms in immunosuppressed organ homograft recipients who were apparently free of cancer before and at the time of transplantation, multiple tumors are infrequent in these patients. A review of the literature reveals that this is the first case in which more than two cancers have occurred concurrently and it is also the first report of carcinoid tumors occurring in a transplant recipient.