{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:35:11Z","timestamp":1760150111355,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA016672","KC200096P1"],"award-info":[{"award-number":["P30 CA016672","KC200096P1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"United States Department of Defense","doi-asserted-by":"publisher","award":["P30 CA016672","KC200096P1"],"award-info":[{"award-number":["P30 CA016672","KC200096P1"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"name":"V Foundation","award":["P30 CA016672","KC200096P1"],"award-info":[{"award-number":["P30 CA016672","KC200096P1"]}]},{"name":"Renal Medullary Carcinoma Research Foundation","award":["P30 CA016672","KC200096P1"],"award-info":[{"award-number":["P30 CA016672","KC200096P1"]}]},{"name":"Chris \u201cCJ\u201d Johnson Foundation","award":["P30 CA016672","KC200096P1"],"award-info":[{"award-number":["P30 CA016672","KC200096P1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Clear cell carcinomas of M\u00fcllerian origin have a strong female predominance and only extremely rarely will arise within the kidney, presumably due to ectopic M\u00fcllerian embryogenesis. Herein, we report a unique case of metastatic M\u00fcllerian type clear cell carcinoma in a 37-year-old patient who had previously received a transplanted kidney from his father at age 11 (due to severe bilateral vesicoureteral reflux) and remained on chronic immunosuppression. The tumor was highly aggressive and demonstrated somatic mutations in NF2 and SETD2. Imaging of the transplanted kidney did not reveal any clear evidence of malignancy. However, targeted multigene sequencing and short tandem repeat testing revealed that the cancer was of donor origin, presumably from ectopic M\u00fcllerian tissue transplanted to the patient along with the kidney graft. The tumor was resistant to first-line therapy with a triple combination of carboplatin plus paclitaxel plus bevacizumab, as well as to second-line immunotherapy with nivolumab plus ipilimumab after tapering down the patient\u2019s immunosuppression. Despite the tumor being genetically distinct from the host, the use of immune checkpoint therapy with nivolumab plus ipilimumab did not yield a response. This unique case showcases the value of molecular testing in determining the tumor origin in patients with solid organ transplants who present with cancers of unknown primary. This can prompt the potential investigation of other recipients from the same donor.<\/jats:p>","DOI":"10.3390\/curroncol30100651","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T01:07:13Z","timestamp":1696554433000},"page":"9019-9027","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["M\u00fcllerian-Type Clear Cell Carcinoma of Donor Origin in a Male Patient with a Kidney Transplant: Ascertained by Molecular Testing"],"prefix":"10.3390","volume":"30","author":[{"given":"J. Bryan","family":"Iorgulescu","sequence":"first","affiliation":[{"name":"Molecular Diagnostics Laboratory, Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah K.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asif","family":"Rashid","sequence":"additional","affiliation":[{"name":"Molecular Diagnostics Laboratory, Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"},{"name":"Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priya","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sreedhar","family":"Mandayam","sequence":"additional","affiliation":[{"name":"Department of Section of Nephrology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyur P.","family":"Patel","sequence":"additional","affiliation":[{"name":"Molecular Diagnostics Laboratory, Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen M.","family":"Schmeler","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-8626","authenticated-orcid":false,"given":"Richard K.","family":"Yang","sequence":"additional","affiliation":[{"name":"Molecular Diagnostics Laboratory, Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"},{"name":"Department of Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6505-8308","authenticated-orcid":false,"given":"Pavlos","family":"Msaouel","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"},{"name":"Department of Translational Molecular Pathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"},{"name":"David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"674748","DOI":"10.1155\/2012\/674748","article-title":"Clear cell carcinomas of the mullerian system: Does the pathogenesis vary depending on their nuclear grade and their association with endometriosis? An immunohistochemical analysis","volume":"2012","author":"Alduaij","year":"2012","journal-title":"Pathol. Res. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1111\/IGC.0b013e3181a44f4","article-title":"Vaginal and (uncommon) cervical cancers in the Netherlands, 1989\u20132003","volume":"20","author":"Helmerhorst","year":"2010","journal-title":"Int. J. Gynecol. 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