Different Course of Nonpigmented Skin Cancers in Patients Treated with Immunosuppression after Organ Transplantation: A Case Series.

Introduction: In 2023, solid organs were transplanted in 1,400 patients in Poland. Nonmelanoma skin cancer such as squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) is the most common malignancy in solid organ transplant recipients. Aims of the study were to present cases and discuss the possible course of skin cancer in patients after organ transplantation.

Case presentation: The study involved 3 patients after organ transplantation treated for skin cancer in the Department of Plastic Surgery of the University of Gdańsk in the years 2020-2023. Each patient is an example of a different course of the disease. In the case of patients treated with immunosuppression, a more aggressive course of the cancer should be considered, which may take various forms. One of the variants that we are dealing with in the first patient is the occurrence of multiple lesions, the co-occurrence of SCC and BCC, and frequent local recurrences. In the case of the second patient, we are dealing with a very aggressive course despite the early initiation of appropriate treatment. Another example of a different course is an atypical clinical picture that makes it difficult to make the correct diagnosis, which we observe in the third patient.

Conclusions: Our study demonstrates that due to the much higher morbidity, aggressive, rapid progression of the skin cancer disease, and unfavorable prognosis, population after transplantation requires a special oncological approach.