Rapid development of esophageal squamous cell carcinoma after liver transplantation for alcohol-induced cirrhosis.
Liver transplant recipients have an increased risk of developing de novo malignancies. It is generally accepted that chronic alcohol abuse is a contributive factor in the pathogenesis of several malignancies, in particular, of oropharyngeal squamous cell carcinoma (SCC). Thus, patients with end-stage alcohol-induced cirrhosis could be at risk of esophageal SCC following orthotopic liver transplantation (OLT). From January 1986 to December 1997 a total of 313 patients underwent OLT for various indications. Of these patients, 72 had alcohol-related cirrhosis. Oropharyngeal and esophageal malignancies after OLT were not observed in non-alcoholic patients. In contrast, these malignancies were diagnosed in three male patients who underwent transplantation for alcohol-induced cirrhosis (incidence 4.2%). Furthermore, all patients had a history of tobacco abuse. The tumors were located in the tongue of one patient and in the esophagus of two patients. While SCC of the tongue became apparent 5 years after OLT, esophageal SCC was detected 8 and 16 months after transplantation. Shortly before transplantation, endoscopy of the esophagus had not revealed evidence of pre-malignant dysplastic lesions in any of these patients. Thus, esophageal SCC may develop rapidly in patients undergoing transplantation for alcohol-related cirrhosis with a history of tobacco abuse before liver transplantation, which warrants careful post-transplant screening of these patients.
Kenngott
Silke
S
Department of Medicine II, Klinikum Grosshadern, LMU Munich, Marchionistrasse 15, 81377, Munich, Germany.
Gerbes
Alexander L
AL
Schauer
Rolf
R
Bilzer
Manfred
M
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D004938:Esophageal Neoplasms / Q000209:etiology*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014062:Tongue Neoplasms / Q000209:etiology