title: An unusual cause of cancer mimicry following liver transplantation.
abstract: Sirolimus is an approved anti-rejection agent following liver or kidney transplantation that works through inhibition of the mammalian target of rapamycin (mTOR). As sirolimus functions through a pathway independent of calcineurin inhibition, it may have less potential for nephrotoxicity and carcinogenesis. That being said, there are a myriad of potential adverse effects reported with sirolimus, many of which are severe and unknown or poorly understood. Herein we present a case of sirolimus causing a serious but uncommon adverse event in an adult liver transplant recipient; the adverse event in this instance unfortunately resulted in significant medical testing and morbidity. The adverse event profile of sirolimus is summarized through review of available evidence.
authors.affiliation: Division of Gastroenterology, Multi-Organ Transplant Program, University of Western Ontario, London, Ontario, Canada.
authors.forename: Karim
authors.initials: K
authors.lastname: Qumosani
authors.forename: Natasha
authors.initials: N
authors.lastname: Chandok
mesh_terms: D000368:Aged; D002278:Carcinoma in Situ / Q000139:chemically induced* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005234:Fatty Liver / Q000150:complications / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D065626:Non-alcoholic Fatty Liver Disease; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced* / Q000175:diagnosis*; D028761:Withholding Treatment
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus