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We are reporting a case of squamous cell carcinoma of the native kidney in a renal
transplant recipient. A 54-year-old gentleman, a renal transplant recipient for three years,
presented with flank pain. On evaluation he was found to have a mass in the upper pole of
the left native kidney. Renal angiogram was done which showed a functioning transplanted
kidney with a large mass arising from the upper pole of the left native kidney. He
underwent nephrectomy. The histopathology reported a squamous cell carcinoma. He was
given adjuvant radiotherapy to the tumor bed using image guided radiotherapy thereby
delivering a differential dose to the high risk areas and preserving the surrounding normal
structures. He developed a urethral nodule which was found to be a squamous cell carcinoma.
The lesion was excised with clear margins. We present this case because it is rare
and to discuss adjutant management.