Neuroendocrine tumors are uncommon
cancers characterized by a slow grow rate. Unresectable liver
metastases are the main cause of death in patients with these
tumors. This is the first Argentine report of a
liver transplantation as an indication for the treatment of unresectable liver
metastases from a pancreatic
neuroendocrine tumor. We present a 48-year-old woman with diagnosis of a pancreatic
neuroendocrine tumor with multiple bilobar unresectable liver
metastases. A splenopancreatectomy was performed after a complete staging revealed absence of extrahepatic disease. Six months later, a follow-up performed with thoracoabdominal CT scan and octreo-scan was consistent with no
tumor recurrence or extrahepatic disease. As the huge
hepatomegaly caused a notorius deterioration in the patient's quality of life, we decided to include her in the waiting list for
liver transplantation. Priority points were requested to the MELD (model for
end stage liver disease) Exceptions Experts Committee with a positive response. Twelve months after the primary surgery, with a MELD score of 23 points, a deceased donor
liver transplantation was performed without evidence at that moment of residual disease. Eighteen months after
liver transplantation, the patient required the surgical repair of a
stenosis in the biliary anastomosis. At the surgery peritoneal
tumor recurrence was diagnosed. Now, 24 months after
liver transplantation the patient has an excellent quality of life and a well functioning graft. We report this case of a
liver transplantation as an indication for the treatment of liver
metastases from a
neuroendocrine tumor and we review the literature on this controversial issue.