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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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Computed tomography colonography and radiation risk:How low can we go?

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World Journal of Gastrointestinal Endoscopy 2021年第3期13卷 72-81页

作者： jelena popic Sandra Tipuric Ivan Balen Anna Mrzljak Department of Radiology University Hospital MerkurSchool of MedicineUniversity of ZagrebZagreb 10000Croatia Department of Family Medicine Health Center Zagreb-EastZagreb 10000Croatia Department of Gastroenterology and Endocrinology General Hospital Slavonski brod“Dr.Josip Bencevic”Slavonski Brod 35000Croatia Department of Medicine Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia

Computed tomography colonography(CTC)has become a key examination in detecting colonic polyps and colorectal carcinoma(CRC).It is particularly useful after incomplete optical colonoscopy(OC)for patients with sedation risks and patients anxious about the risks or potential discomfort associated with ***'s main advantages compared with OC are its non-invasive nature,better patient compliance,and the ability to assess the extracolonic *** these advantages,ionizing radiation remains the most significant burden of *** opinion review comprehensively addresses the radiation risk of CTC,incorporating imaging technology refinements such as automatic tube current modulation,filtered back projections,lowering the tube voltage,and iterative reconstructions as tools for optimizing low and ultra-low dose protocols of *** perspectives arise from integrating artificial intelligence in computed tomography machines for the screening of CRC.

关键词： Computed tomography colonography Colorectal cancer Radiation risk Image quality Image noise Iterative reconstruction

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