title: Pancreatic cancer in cystic fibrosis after bilateral lung transplantation.
abstract: Cystic fibrosis (CF) is the most common lethal genetic disease affecting 1 in 2500 white patients. Chronic obstructive lung disease and pancreatic insufficiency are the main clinical manifestations of CF. Lung transplantation has become a treatment option for advanced pulmonary disease during the last decade. On the other hand, there is evidence from large cohort studies that CF and immunosuppression are risk factors for pancreatic cancer. Here, we report the case of an 18-year-old female patient with CF and bilateral lung transplantation who underwent Whipple procedure for pancreatic adenocarcinoma at the age of 12 years. Because of growth retardation, the patient underwent a 2-year period of growth hormone treatment before the diagnosis of pancreatic cancer. This case should sensitize physicians to be aware of the increased risk for pancreatic cancer in CF patients especially in those after lung transplantation with immunosuppression and prolonged survival.
authors.affiliation: Swiss Hepato-Pancreato-Biliary Center, Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Switzerland.
authors.forename: Henrik
authors.initials: H
authors.lastname: Petrowsky
authors.forename: Horst
authors.initials: H
authors.lastname: Schuster
authors.forename: Sarosh
authors.initials: S
authors.lastname: Irani
authors.forename: Markus
authors.initials: M
authors.lastname: Schäfer
authors.forename: Wolfram
authors.initials: W
authors.lastname: Jochum
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Clavien
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000293:Adolescent; D002758:Cholangiography; D003550:Cystic Fibrosis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D019382:Human Growth Hormone / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016040:Lung Transplantation; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011994:Recombinant Proteins / Q000009:adverse effects; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D019382:Human Growth Hormone