肝细胞癌肝移植术后供体来源肝内胆管癌1例罕见病例报告
A Rare Case of Donor-Origin Intrahepatic Cholangiocarcinoma After Liver Transplantation for Hepatocellular Carcinoma: A Case Report.
作者信息
Uemoto Yusuke, Taura Kojiro, Yamada Yosuke, Takeda Haruhiko, Nakano Shigeharu, Takai Atsushi, Haga Hironori, Hatano Etsuro
机构信息
Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.
Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Gastroenterological Surgery and Oncology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
出版信息
Transplant Proc. 2023 Oct;55(8):1964-1967. doi: 10.1016/j.transproceed.2023.07.010. Epub 2023 Aug 5.
BACKGROUND
Tumors may develop in the grafted liver after liver transplantation for hepatocellular carcinoma, most of which are hepatocellular carcinoma recurrences and are rarely of donor origin. We report a rare case of donor-origin intrahepatic cholangiocarcinoma in a liver allograft after liver transplantation for hepatocellular carcinoma.
METHODS
A man in his 60s underwent liver transplantation for hepatocellular carcinoma with hepatitis C virus cirrhosis. The donor was a braindead woman in her 60s who had no history of malignancy.
RESULTS
Three years and 5 months after liver transplantation, a tumor developed in the allograft. Computed tomography scans showed a 40-mm tumor that was atypical for hepatocellular carcinoma. Tumor biopsy was most suggestive of intrahepatic cholangiocarcinoma. Fluorescence in situ hybridization of the tumor showed an XX signal pattern, suggesting that it originated from the donor liver. Whole exome sequencing analysis strongly suggested that the tumor was an intrahepatic cholangiocarcinoma derived from the donor.
CONCLUSIONS
Although donor-origin cancer after liver transplantation is extremely rare, it should be considered for adequate treatment.
背景
肝细胞癌肝移植后，移植肝可能会发生肿瘤，其中大部分是肝细胞癌复发，很少是供体来源。我们报告了1例肝细胞癌肝移植后供体来源的肝内胆管癌罕见病例。
方法
一名60多岁男性因肝细胞癌合并丙型肝炎病毒肝硬化接受肝移植。供体是一名60多岁的脑死亡女性，无恶性肿瘤病史。
结果
肝移植后3年5个月，移植肝出现一个肿瘤。计算机断层扫描显示一个40毫米的肿瘤，其表现不典型，不符合肝细胞癌特征。肿瘤活检最提示为肝内胆管癌。肿瘤的荧光原位杂交显示XX信号模式，提示其起源于供体肝脏。全外显子测序分析强烈提示该肿瘤是源自供体的肝内胆管癌。
结论
尽管肝移植后供体来源的癌症极为罕见，但仍应考虑进行适当治疗。
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