Non Melanoma Skin Cancers in Solid Organ Transplant Recipients: A Single Center Experience

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Abstract

Introduction

Malignant skin cancers are one of the most common malignancies in solid organ transplant recipients (SOTR). The increased risk of developing skin malignancies after organ transplant is due to age and immunosuppressive drug usage. The aim of this study is to estimate non melanocytic skin cancer incidence and the development time of skin cancers after transplantation in our center.

Materials and Methods

A total of 1833 transplant recipients (Kidney, liver and heart transplantation) who have been operated between 1996 and 2016 in organ transplant unit at University of Baskent were viewed retrospectively. Melanocytic skin cancers, premalignant lesions and benign skin tumors were excluded from the study.

Results

68.4% of the recipients were male, 31.6% female. Among these patients, 1133 were renal recipients (61.8%), 512 were liver recipients (27.9%) and 120 heart recipients (6.5%). A total of 22 patients (18 renal, 3 liver and one heart recipients) developed 23 different skin cancer. The mean age at presentation was 55.8 (37-71). Average time to develop skin malignancy after transplantation was 6.8 years (1-13 year). The most common skin cancer was Basal Cell Carcinoma (BCC) 43%, followed by squamous cell carcinoma (SCC) 39%, and lastly Kaposi’s sarcoma with an incidence of 13%. These tumors were located in head and neck region (15 cases), lower extremity (3 cases), upper extremity (2 cases) and trunk (2 cases). Prevalence of skin cancer among our SOTRs in general was 1.25%.

Conclusion

Cutaneous malignancies are still counting one of the most common malignancies in SOTR with decreasing rate due to post-transplant immunosuppressive protocol and the increased awareness about sun protection rule in preventing skin cancers. We suggest routine and close dermatological follow-up of transplant recipients to detect and treat early skin cancer and premalignant lesions and thus lowering morbidity and mortality.

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