Case History (164 words):

Before undergoing kidney transplantation, a 70-year-old female with end-stage renal failure secondary to ADPKD was admitted for bilateral nephrectomy due to significant nephromegaly. Her past medical history included a stage I myxoid liposarcoma of the left leg, removed 4 years earlier, a pacemaker for an atrioventricular block and high blood pressure necessitating four antihypertensive medications. See timeline in Figure 1. The follow-up for her sarcoma involved annual radiological controls, which were systematically discussed in a tumour board with close collaboration among radiologists, nephrologists, oncologists, and surgeons. A PET-CT 18F-FDG scan, requested to rule out a neoplastic lesion, revealed a 6 cm right internal pararenal lesion and a 6.2 cm left internal pararenal lesion with a necrotic centre. The investigation was complemented by magnetic resonance imaging, which showed nothing suspicious and stable lesions on both sides. (Figure 2) Antihypertensive therapy was intensified following the pre-anaesthetic outpatient consultation a week before admission. Dialysis was performed the day before surgery. See preoperative biological parameters in Table 1.