title: Living donor liver transplantation in a pediatric patient with preexisting yolk sac tumor.
abstract: There is ongoing discussion regarding the indications and timing of LT for patients with a preexisting extrahepatic malignancy. We herein report a pediatric case that underwent LDLT after therapy for YST. The patient, a 13-year-old female with biliary atresia, had undergone portoenterostomy at 2 months of age. She developed a left ovarian tumor with a high serum alpha-fetoprotein concentration at 10 years of age. She underwent left oophorectomy and was diagnosed with ovarian YST (Stage I). After surgery, hepatopulmonary syndrome progressed gradually. She was examined carefully and exhibited no findings to suggest the recurrence of YST. We decided to perform LDLT at 3 years and 6 months of age after the surgery for YST. The patient is currently alive and doing well without recurrence of YST at approximately 2 years after transplantation. There is no significant difference between the recurrence rate of preexisting extrahepatic malignancy and the incidence of de novo malignancy if specific cases are selected. The indications and period from surgery for preexisting extrahepatic malignancy to LT should thus be determined according to the type and stage of cancer.
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Taiichi
authors.initials: T
authors.lastname: Wakiya
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Toyoki
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Keinosuke
authors.initials: K
authors.lastname: Ishido
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kudo
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Tsutsumi
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Odagiri
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Suto
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Uchida
authors.affiliation: Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hakamada
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications / Q000601:surgery*; D018240:Endodermal Sinus Tumor / Q000150:complications / Q000601:surgery*; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis; D006801:Humans; D007165:Immunosuppression Therapy; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D010051:Ovarian Neoplasms / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D012008:Recurrence; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins
keywords: de novo malignancy; liver transplantation; pediatric; preexisting extrahepatic malignancy; recurrence; yolk sac tumor