Malignant hepatic tumor occurring 10 yrs after a histocompatible sibling donor bone marrow transplantation for severe aplastic anemia.
A 13-yr-old boy developed post-transplant liver tumor. At three yrs of age, this patient underwent a histocompatible sibling donor BMT for severe aplastic anemia, after a conditioning with antithymocyte globulin and cyclophosphamide. He became a HBV carrier after BMT. Stable mixed chimerism and mild thrombocytopenia, but no active hepatitis continued. At age 13, abdominal pain was a sign of massive tumor. Extremely high levels of alpha-fetoprotein indicated the clinical diagnosis of hepatoblastoma that might be the first report as post-BMT malignancy. The necropsy specimens revealed that the tumor was recipient cell-origin and showed the histopathological features of both hepatoblastoma and hepatocellular carcinoma. Prolonged mixed chimerism and hepatitis virus infection might induce a rare oncogenesis after non-irradiated conditioning.
Ishimura
Masataka
M
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ohga
Shouichi
S
Nagatoshi
Yoshihisa
Y
Okamura
Jun
J
Tajiri
Tatsuro
T
Kohashi
Kenichi
K
Oda
Yoshinao
Y
Takada
Hidetoshi
H
Hara
Toshiro
T
D000741:Anemia, Aplastic / Q000601:surgery*; D016026:Bone Marrow Transplantation / Q000379:methods*; D002675:Child, Preschool; D017809:Fatal Outcome; D005500:Follow-Up Studies; D018197:Hepatoblastoma / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology*; D019520:Living Donors; D008297:Male; D035781:Siblings; D013997:Time Factors; D014057:Tomography, X-Ray Computed