A case of esophageal adenocarcinoma on long-term rapamycin monotherapy.
Cancer in transplant recipients represents a therapeutic challenge even when the patient is already under mTOR inhibitors. A 78-year-old man received a deceased donor kidney transplant in 1993. After 6 months, he developed a multifocal cutaneous and nonvisceral Kaposi's Sarcoma while on cyclosporine immunosuppressant therapy. The patient was converted to sirolimus monotherapy in 2001 with subsequent complete recovery within 2 years. In 2007, the patient was diagnosed with an esophageal adenocarcinoma stage IIA. An esophagectomy was performed without requirement of further treatment. He has continued on sirolimus monotherapy ever since, with no other incidents and no recurrences of either tumor. In this report, we describe an interesting case of a second cancer while on immunosuppressive therapy with anticancer activity. Moreover, the present knowledge of the matter is discussed.
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.|Department of Medicine, Universitat de Barcelona, Barcelona, Spain.
Catarina
C
Canha
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.|Department of Medicine, Universitat de Barcelona, Barcelona, Spain.
Raquel
R
Ferreira
Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació Clínic - IDIBAPS, Barcelona, Spain.
Jordi
J
Rovira
Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació Clínic - IDIBAPS, Barcelona, Spain.
Daniel
D
Moya-Rull
Department of Medicine, Universitat de Barcelona, Barcelona, Spain.|Department of Gastroenterology, Hospital Clínic, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.|Gastrointestinal and Pancreatic Oncology, IDIBAPS, Barcelona, Spain.
Antoni
A
Castells
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.|Department of Medicine, Universitat de Barcelona, Barcelona, Spain.|Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació Clínic - IDIBAPS, Barcelona, Spain.
Fritz
F
Diekmann
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.|Department of Medicine, Universitat de Barcelona, Barcelona, Spain.|Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació Clínic - IDIBAPS, Barcelona, Spain.
Federico
F
Oppenheimer
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.|Department of Medicine, Universitat de Barcelona, Barcelona, Spain.|Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació Clínic - IDIBAPS, Barcelona, Spain.
Josep Maria
JM
Campistol
Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.|Department of Medicine, Universitat de Barcelona, Barcelona, Spain.|Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació Clínic - IDIBAPS, Barcelona, Spain.
Ignacio
I
Revuelta
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D015415:Biomarkers; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D057915:Drug Substitution; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D009363:Neoplasm Proteins / Q000378:metabolism; D016609:Neoplasms, Second Primary / Q000601:surgery; D010766:Phosphorylation; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011499:Protein Processing, Post-Translational; D012514:Sarcoma, Kaposi / Q000209:etiology; D015398:Signal Transduction; D020123:Sirolimus / Q000009:adverse effects / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000209:etiology; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors / Q000378:metabolism
D015415:Biomarkers; D007166:Immunosuppressive Agents; D009363:Neoplasm Proteins; D016572:Cyclosporine; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D001379:Azathioprine; D011241:Prednisone; D020123:Sirolimus
TOR-inhibitors; immunosuppression; immunosuppression clinical; kidney clinical; malignancies and long term compliations; molecular diagnostic; solid tumors