Very late recurrence of hepatocellular carcinoma after liver transplantation: case report and literature review.
Hepatocellular carcinoma (HCC) recurs in 10% to 60% of the patients after liver transplantation (OLT) and is associated with increased mortality. The average time to recurrence ranges from 1 to 2 years following OLT, and the median survival from the time of diagnosis is about 1 year. We report a case of a 69-year-old man who underwent OLT for hepatitis C virus-related cirrhosis with HCC, and was diagnosed with recurrent HCC 6.5 years after OLT. Biopsies from the initial and recurrent tumors showed a well-differentiated HCC with foci of clear cell pattern. The patient was still alive and asymptomatic 32 months after the diagnosis despite extensive tumor burden. He expired 9 years, 9 months after OLT and 3 years, 2 months after the detection of recurrence. In conclusion, HCC may recur more than 6 years after OLT and may exhibit an indolent course. This case illustrates the highly variable rate of tumor growth and progression post-OLT. The impact of this information on the need for long-term surveillance for recurrent HCC post-OLT remains to be determined.
Schreibman
I R
IR
Division of Hepatology, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida 33136, USA.
Bejarano
P
P
Martinez
E J
EJ
Regev
A
A
D000368:Aged; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D013997:Time Factors