Metastasis of an urothelial carcinoma as rare cause of an AV-graft dysfunction in a transgender patient.

A 66-year-old transfeminine patient presented to our institution with a central-venous stenosis causing dysfunction of her arteriovenous (AV) graft on her left arm. The patient was treated repeatedly, because of restenosis. Due to complete occlusion of the graft and subclavian vein as well as a liquid tumor located around the stenotic segment of the vein, we resected the left subclavian vein via a trap-door thoracotomy and inserted a PTFE-graft. Histological examination of the resected tissue identified metastasis from the urothelial carcinoma as the underlying cause of the stenosis. Malignant tumors are an infrequent etiology of AV-access dysfunction, and there are hardly any data on transgender patients. This case report provides an overview of the current data concerning these unique circumstances.