Department of Orthopedics, 175th Hospital of the PLA, Xiamen University Affiliated Hospital, Zhangzhou, 363000 Fujian, China.
Clin Orthop Relat Res. 2012 Apr;470(4):1232-5. doi: 10.1007/s11999-011-2236-9. Epub 2012 Jan 4.
De novo malignancies are serious complications in the late postoperative period after liver transplantation. The most common de novo tumors are skin malignancies, posttransplantation lymphoproliferative disorder, tumors of the head and neck, and Kaposi's sarcoma. Such posttransplant de novo malignancies are apparently rarely found in bone.
We describe a patient with a low-grade, aggressive fibrous histiocytoma of the scapula. The patient had undergone liver transplantation 6 years earlier. En bloc resection of the tumor and limb salvage was performed. At the 2-year followup the patient had no signs of local recurrence or metastatic spread; the patient had a Musculoskeletal Tumor Society (MSTS) score of 87.
A literature review suggests the main predisposing factors to such malignancies are immunosuppression and its length of use. According to the literature, tumors apparently are rare in bone after liver transplantation, with no clearly documented cases. However, in the presence of such a finding, our study might be the first clearly documented case study of this kind of bone tumor.
We describe a patient with a bone tumor after liver transplantation. Our literature review suggests liver transplantation and long-term immunosuppression played a role in this patient's tumor.
肝移植后晚期发生新发恶性肿瘤是严重的并发症。最常见的新发肿瘤为皮肤恶性肿瘤、移植后淋巴组织增生性疾病、头颈部肿瘤和卡波西肉瘤。这种肝移植后的新发恶性肿瘤显然很少发生在骨骼。
我们描述了 1 例发生于肩胛部的低级别侵袭性纤维组织细胞瘤患者。该患者在 6 年前接受了肝移植。实施了肿瘤整块切除和保肢手术。2 年随访时,患者没有局部复发或远处转移的迹象;患者的肌肉骨骼肿瘤学会(MSTS)评分为 87。
文献回顾提示发生此类恶性肿瘤的主要诱发因素为免疫抑制及其使用时间。根据文献,肝移植后骨骼中的肿瘤显然很少见,没有明确记录的病例。然而,在存在这种发现的情况下,我们的研究可能是首例明确记录的此类骨肿瘤的病例研究。
我们描述了 1 例肝移植后发生骨肿瘤的患者。我们的文献回顾提示肝移植和长期免疫抑制在该患者的肿瘤发生中起了作用。