Zittel T T, Mehl C F R, Reichmann U, Becker H D, Jehle E C
Department of General, Visceral and Transplantation Surgery, University Hospital, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany.
Langenbecks Arch Surg. 2004 Feb;389(1):6-10. doi: 10.1007/s00423-003-0422-2. Epub 2003 Oct 22.
Organ transplantation is a standard procedure today. Due to immunosuppressive drugs and increasing survival after organ transplantation, patients with transplanted organs carry an increased risk of developing malignant tumours. Accordingly, more patients with malignant tumours after transplantation will be faced by general or oncology surgeons. We report the case of a 48-year-old patient with advanced rectal cancer 6.5 years after pancreas-kidney-transplantation for type I diabetes.
The patient was treated with neo-adjuvant radio-chemotherapy, followed by low anterior rectal resection with total mesorectal excision. Consecutively, a solitary hepatic metastasis, a solitary pulmonary metastasis and a chest wall metastasis were resected over the course of 13 months.
The patient eventually died of metastasized cancer 32 months after therapy had been initiated, his organ grafts functioning well until his death.
Our case report provides evidence that transplantation patients should receive standard oncology treatment, including neo-adjuvant treatment, so long as their general condition and organ graft functions allow us to do so, although a higher degree of morbidity might be encountered.
