Dear Editor,

We have read the article by Ercam et al. in the Clinical Case Section of Nefrologia about a case of Kaposi's sarcoma in a transplant recipient.1 Renal transplantation and immunosuppressive medication used for it leads to a high rate of tumors and among them Kaposi's sarcoma is common. There is extensive literature on the development of malignancies after renal transplantation, so the description of another case does not seem to justify its publication. However, what seems novel and so the authors justify its interest is the prematurity of the Kaposi´s sarcoma development (only 4 months after renal transplantation), together with the authors statement that this would be the first reported case with this precocity.1

In 1990 we published a case of Kaposi's sarcoma associated with renal transplant developed 4 years after kidney transplant2 and in which the skin lesions stabilized after withdrawing immunosuppressive medication. In the discussion of the case we pointed out references describing cases in 1979 and the time of appearance of the tumor could be even after three months of transplantation.3 Interestingly before the time of our communication there have been published some references describing cases where tumor appear between first and 4 months after renal transplantation.4,5

It is true that most of the cases described in the literature the time elapsed from transplant to tumor development are longer than that of Ercam et al. and the well documented case by this authors is unusual on this matter, however it is also true that we get used to refer recent references in our publications, without taking into account some previous periods. To be fair we should not forget that it is not easy to find past issues, either completely or it abstract. Finally note that these circumstances should encourage us to avoid statements like "the first or only case or reference" given the lack of access to all available information.

Conflict of interest

The authors declare that they have no conflicts of interest related to the contents of this article.