De-novo cholangiocarcinoma in the setting of recurrent primary sclerosing cholangitis following liver transplant.
Orthotopic liver transplantation is the only definitive therapeutic option in patients with primary sclerosing cholangitis (PSC) and end-stage liver disease. However, PSC recurs in up to 20% of patients transplanted for this indication. To date, no patient has been reported to develop cholangiocarcinoma (CCA) post-transplant, without biliary tract cancer having been present pretransplant. Here, we report recurrent PSC complicated by de-novo CCA in a 31-year-old man transplanted for PSC 8 years earlier. Cholangiocarcinoma was confirmed using a combination of computed tomography, cholangiography, positron emission tomography and histological examination of biliary cytology. He has since been successfully re-transplanted following preoperative chemo-radiotherapy. No viable tumor was identified in the explanted liver. This case establishes that long-term complications associated with PSC and biliary-enteric surgery such as CCA may become apparent in new grafts post-transplant.
Heneghan
Michael A
MA
Division of Gastroenterology, Duke University Medical Center, Durham, NC, USA. heneg003@mc.duke.edu
Tuttle-Newhall
J Elizabeth
JE
Suhocki
Paul V
PV
Muir
Andrew J
AJ
Morse
Michael
M
Bornstein
Jeffrey D
JD
Sylvestre
Pamela B
PB
Collins
Bradley
B
Kuo
Paul C
PC
Rockey
Don C
DC
D000328:Adult; D001650:Bile Duct Neoplasms / Q000209:etiology / Q000628:therapy; D001652:Bile Ducts / Q000473:pathology; D018281:Cholangiocarcinoma / Q000209:etiology* / Q000628:therapy; D002758:Cholangiography; D015209:Cholangitis, Sclerosing / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D012008:Recurrence; D013997:Time Factors; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed