title: Development of Allograft Cancer after Lung Transplantation: A Case Report.
abstract: BACKGROUND
  In contrast to skin cancer and lymphoproliferative disorders, de-novo lung allograft cancer is seldom reported after lung transplantation.
  
  
  METHODS
  A 19-year-old patient with severe pulmonary hypertension listed urgently for lung transplantation underwent successful bilateral lung transplant procedure receiving lungs from a 55-year-old donor with a smoking history of 30 pack years. After 3.5 years of lung transplantation, a locally advanced squamous cell carcinoma in the left lung allograft was diagnosed. Extended (intra-pericardial) left pneumonectomy was successfully performed, but the patient died a few weeks later due to acute respiratory distress syndrome.
  
  
  CONCLUSIONS
  Usage of extended criteria donors seems a successful strategy to overcome shortage of donor lungs by the increasing number of lung transplant candidates. However, this approach might increase the risk of novel development of lung allograft cancer, a potential fatal complication that must be considered during follow-up of lung transplant recipients.
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Esther I
authors.initials: EI
authors.lastname: Schwarz
authors.affiliation: Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Bart
authors.initials: B
authors.lastname: Vrugt
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Lars C
authors.initials: LC
authors.lastname: Huber
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Murer
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Mace M
authors.initials: MM
authors.lastname: Schuurmans
authors.affiliation: Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
mesh_terms: D064591:Allografts; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000601:surgery*; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011013:Pneumonectomy; D000072078:Positron Emission Tomography Computed Tomography; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: allograft cancer; donor selection; lung transplantation