Cancer after solid organ transplant

Q: 54 years old male with a previous history of  kidney transplant twice, is admitted to ICU with sepsis and enlarged lymph nodes. On clinical exam also found to have scaly, erythematous nodules on his skin. Which is the most common cancer in solid organ transplant recipients? (select one)

A) Lymphoma

B) Skin cancer

Answer: B

Cutaneous malignancy is the most common malignancy post solid organ transplant, counting for almost 40% of all cancers in solid organ transplants. The most common are cutaneous squamous cell carcinoma and basal cell carcinoma. The most common risk factors are

• intensity of immunosuppression
• duration of immunosuppression
• ethnicity (in 50% of white or fair skin vs. only 6% on dark skin)
• sun exposure 
• geographic location

#oncology

References:

1. Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med 2003; 348:1681.

2. Chung CL, Nadhan KS, Shaver CM, et al. Comparison of Posttransplant Dermatologic Diseases by Race. JAMA Dermatol 2017; 153:552.

3. Garrett GL, Blanc PD, Boscardin J, et al. Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States. JAMA Dermatol 2017; 153:296.