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The report describes a 63-year-old male kidney transplant recipient who developed a 1.4 cm enhancing renal mass during evaluation for retransplantation. CT, MRI, and PET-CT suggested malignancy, prompting transplant nephrectomy. Histopathology confirmed AH with benign anastomosing capillary-sized vessels and positive endothelial markers, preventing delay in subsequent living donor retransplantation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/anastomosing-hemangioma-masquerading-as-renal-cell-carcinoma-in-a-transplanted-kidney-case-report/459498/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/anastomosing-hemangioma-masquerading-as-renal-cell-carcinoma-in-a-transplanted-kidney-case-report/459498.png","ImageObject",300,407,{"name":92,"@type":93},"\tJames","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What imaging findings led clinicians to suspect renal cell carcinoma in this case?","Question",{"text":112,"@type":113},"Contrast-enhanced CT showed a small well-circumscribed enhancing mass, MRI demonstrated a T2 hyperintense lesion with heterogeneous and delayed enhancement, and PET-CT showed no hypermetabolic uptake or metastasis. Despite the negative PET-CT, the overall imaging appearance was highly suspicious for RCC.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the diagnosis of anastomosing hemangioma confirmed?",{"text":117,"@type":113},"Histopathology revealed anastomosing capillary-sized vascular channels lined by bland endothelial cells without cytologic atypia, consistent with AH. Immunohistochemistry was positive for CD34 and ERG, supporting endothelial differentiation.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was surgical intervention performed and what was the impact on retransplant planning?",{"text":121,"@type":113},"Transplant nephrectomy was performed to exclude malignancy because AH can mimic RCC, particularly in transplant recipients. Accurate pathological diagnosis helped prevent unnecessary delay in living donor retransplantation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459498,1790795023,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Case Report  \nClin Transplant Res 2025;39:384-388 [https://doi.org/10.4285/ctr.25.0095](https://doi.org/10.4285/ctr.25.0095)  \npISSN 3022-6783 eISSN 3022-7712  \nReceived November 19, 2025  \nRevised November 24, 2025  \nAccepted November 24, 2025  \nCorresponding author: Soo Jin Na Choi Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea  \nE-mail: [choisjn@chonnam.ac.kr](choisjn@chonnam.ac.kr)  \n© The Korean Society for Transplantation This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc/4.0/](by-nc/4.0/)) [which](which) permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nAnastomosing hemangioma masquerading as renal cell carcinoma in a transplanted kidney: a case report  \nHong Sung Jung1, Ho Kyun Lee1, Sung Sun Kim2, Soo Wan Kim3, Soo Jin Na Choi1  \n1Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea  \n2Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea  \n3Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea  \nAnastomosing hemangioma (AH) is an exceptionally rare benign vascular neoplasm that can closely mimic renal cell carcinoma (RCC) on radiologic and histopathologic evaluation. We report a 63-year-old male kidney transplant recipient who developed a small enhancing renal mass during pretransplant assessment for a second kidney transplantation. The patient had received a deceased donor kidney transplantation in April 1994 and resumed maintenance hemodialysis in April 2025 due to chronic allograft failure. During evaluation for a planned living donor kidney transplantation from his son, abdominal contrast-enhanced computed tomography revealed a 1.4 cm well-circumscribed enhancing mass in the upper pole of the transplanted kidney, highly suspicious for RCC. Magnetic resonance imaging demonstrated a T2 hyperintense lesion with heterogeneous and delayed enhancement, and positron emission tomography-computed tomography showed no hypermetabolic uptake or metastasis. Transplant nephrectomy was performed to exclude malignancy. Histopathologic examination revealed anastomosing capillary-sized vascular channels lined by bland endothelial cells without atypia, consistent with AH. Immunohistochemical staining was positive for CD34 and ERG, confirming endothelial differentiation. This case emphasizes the diagnostic challenge of distinguishing AH from RCC in transplant recipients and highlights the importance of accurate pathologic diagnosis to prevent unnecessary delay in subsequent kidney transplantation.  \nKeywords: Anastomosing hemangioma; Kidney transplantation; Renal cell carcinoma; Nephrectomy; Case report  \nINTRODUCTION  \nAnastomosing hemangioma (AH) is a rare benign vascular tumor of the kidney, first described by Montgomery and Epstein in 2009 [1] . Histologically, AH is characterized  \nby sinusoid-like anastomosing capillary channels lined by bland endothelial cells without cytologic atypia. Despite its benign nature, AH often radiologically mimics renal cell carcinoma (RCC) owing to its hypervascular enhancement pattern on contrast-enhanced computed tomography (CT)  \n384 [https://doi.org/10.4285/ctr.25.0095](https://doi.org/10.4285/ctr.25.0095)  \nJung HS et al. Anastomosing hemangioma in a transplanted kidney  \nHIGHLIGHTS  \n• Anastomosing hemangioma can closely mimic renal cell carcinoma on imaging.  \n• A small hypervascular graft kidney mass required nephrectomy to exclude malignancy.  \n• Histology revealed benign anastomosing vascular channels with e","cbCaigjty3zHeQ9W","https://ap.wps.com/l/cbCaigjty3zHeQ9W","pdf",7118899,"English","# Introduction\n# Case Report\n# Highlights","[{\"question\":\"What imaging findings led clinicians to suspect renal cell carcinoma in this case?\",\"answer\":\"Contrast-enhanced CT showed a small well-circumscribed enhancing mass, MRI demonstrated a T2 hyperintense lesion with heterogeneous and delayed enhancement, and PET-CT showed no hypermetabolic uptake or metastasis. Despite the negative PET-CT, the overall imaging appearance was highly suspicious for RCC.\"},{\"question\":\"How was the diagnosis of anastomosing hemangioma confirmed?\",\"answer\":\"Histopathology revealed anastomosing capillary-sized vascular channels lined by bland endothelial cells without cytologic atypia, consistent with AH. Immunohistochemistry was positive for CD34 and ERG, supporting endothelial differentiation.\"},{\"question\":\"Why was surgical intervention performed and what was the impact on retransplant planning?\",\"answer\":\"Transplant nephrectomy was performed to exclude malignancy because AH can mimic RCC, particularly in transplant recipients. Accurate pathological diagnosis helped prevent unnecessary delay in living donor retransplantation.\"}]","Anastomosing hemangioma masquerading as renal cell carcinoma in a transplanted kidney - Case report | PDF",1790756052,13]