Confusing Tumoral Lesions in the Chest Wall of a Deceased-Donor Transplant Candidate

Patient selection and preparation for kidney transplantation may pose clinical challenges. A 35-year-old male patient was presented with chest wall tumoral lesions on the day when he was matched with a deceased-donor kidney. Apart from the tumoral lesions, his medical, surgical, and immunologic evaluations were quite favorable to proceed with the operation. Pre-operative thorax surgery and orthopedics consultations were asked for cytopathological evaluation to rule out a possible malignancy. However, considering the cold ischemia time of the donated kidney, there was not enough time to plan and wait for the pathological evaluation of the biopsy. On chest tomography imaging, the expansile tumoral lesions had a lytic-cystic character with well-defined borders. High parathyroid hormone and alkaline phosphatase levels of the patient suggested Brown tumor the most likely diagnosis and we chose to proceed with the operation. Post-operative biopsy findings supported our clinical diagnosis. We herein share the role of clinical evaluation and imaging studies for differential diagnosis of tumoral lesions in kidney transplantation candidates.