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Liver re-transplantation for donor-derived neuroendocrine tumor: A case report

World Journal of Clinical Cases 2019年第18期7卷 2794-2801页

作者： Anna Mrzljak Branislav Kocman Anita Skrtic ivana furac Jelena Popic Lucija Franusic Renata Zunec Davor Mayer Danko Mikulic Department of Medicine Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia Department of Surgery Merkur University HospitalZagreb 10000Croatia Department of Pathology and Cytology Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia DNA Laboratory Institute of Forensic Medicine and CriminalisticsSchool of MedicineUniversity of ZagrebZagreb 10000Croatia Department of Radiology Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Department for Tissue Typing Clinical Hospital Centre ZagrebZagreb 10000Croatia Institute of Forensic Medicine and Criminalistics School of MedicineUniversity of ZagrebZagreb 10000Croatia

BACKGROUND Donor-origin cancer is a well-recognized but rare complication after liver transplantation (LT). The rise in the use of extended criteria donors due to the current shortage of organs increases the risk. Data on donor-origin neuroendocrine neoplasms (NENs) and the most appropriate treatment are scarce. Here, we report a case of a patient who developed a NEN confined to the liver after LT and was treated with liver re-transplantation (re-LT). CASE SUMMARY A 49-year-old man with no other medical co-morbidities underwent LT in 2013 for alcoholic liver cirrhosis. The donor was a 73-year-old female with no known malignancies. Early after LT, a hypoechogenic (15 mm) lesion was detected in the left hepatic lobe on abdominal ultrasound. The lesion was stable for next 11 mo, when abdominal magnetic resonance identified two hypovascular lesions (20 and 11 mm) with atypical enhancement pattern. Follow-up abdominal ultrasound revealed no new lesions for the next 2.5 years, when magnetic resonance showed a progression in size and number of lesions, also confirmed by abdominal computed tomography. Liver biopsy proved a well-differentiated NEN. Genetic analysis of the NEN confirmed donor origin of the neoplasm. As NEN was confined to liver graft only, in 2018, the patient underwent his second LT. At 12 mo after re-LT the patient is well with no signs of NEN dissemination. CONCLUSION The benefits of graft explantation should be weighed against the risks of re-LT and the likelihood of NEN dissemination beyond the graft.

关键词： Donor-origin tumor Neuroendocrine tumor Liver transplantation Donor Case report

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