title: Rectal Carcinoid Tumor With Liver Metastases Treated by Local Excision and Orthotopic Liver Transplant With Long-term Follow-up.
abstract: In patients affected by unresectable liver metastases from neuroendocrine tumor, liver transplant represents currently the only realistic chance for cure. The first attempt to establish selection criteria for liver transplant in patients affected by neuroendocrine tumor liver metastases was made by Mazzaferro and associates in 2007. We report the case of a 46-year-old man who came to our institution in 2006 with right upper quadrant abdominal pain. Diagnosis of rectal neuroendocrine tumor with bilobar liver nodules was made; the patient underwent transanal local resection. A liver biopsy confirmed the metastatic nature of the hepatic lesion, showing a low-grade neuroendocrine tumor (G1, proliferation index Ki-67 <2%). The patient underwent 2 sessions of transarterial chemoembolization that resulted in stable disease. Afterward, the patient underwent a liver transplant, using the piggyback technique without a venous-venous bypass. His postoperative course was uneventful. The patient has been disease-free for 3 years. Posttransplant treatment has played a key role in increasing the overall survival of the patient and assuring him a good quality of life. He died 9 years (102 mo) after liver transplant.
authors.affiliation: Department of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
authors.forename: Gianluca
authors.initials: G
authors.lastname: Mascianà
authors.forename: Edoardo
authors.initials: E
authors.lastname: de Werra
authors.forename: Nicola
authors.initials: N
authors.lastname: Guglielmo
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Levi Sandri
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Coluzzi
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
mesh_terms: D002276:Carcinoid Tumor / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome