title: De-novo cholangiocarcinoma in the setting of recurrent primary sclerosing cholangitis following liver transplant.
abstract: 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.
authors.affiliation: Division of Gastroenterology, Duke University Medical Center, Durham, NC, USA. heneg003@mc.duke.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Heneghan
authors.forename: J Elizabeth
authors.initials: JE
authors.lastname: Tuttle-Newhall
authors.forename: Paul V
authors.initials: PV
authors.lastname: Suhocki
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Muir
authors.forename: Michael
authors.initials: M
authors.lastname: Morse
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Bornstein
authors.forename: Pamela B
authors.initials: PB
authors.lastname: Sylvestre
authors.forename: Bradley
authors.initials: B
authors.lastname: Collins
authors.forename: Paul C
authors.initials: PC
authors.lastname: Kuo
authors.forename: Don C
authors.initials: DC
authors.lastname: Rockey
mesh_terms: 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