De novo hepatocellular carcinoma in a non-cirrhotic allograft 27 years after liver transplantation: A case report.

Abstract

Hepatocellular carcinoma recurrence after liver transplantation is a well-known complication but the development of de novo hepatocellular carcinoma in non-cirrhotic allograft with no previous history of hepatic malignancy either in the donor or the recipient is extremely rare. A 33-year-old man underwent deceased donor liver transplantation due to HBV-HDV cirrhosis in 1991. The donor was healthy, with negative viral serology. Pretransplant assessment and explant liver pathology revealed no tumor. He developed an 8 cm mediastinal thymus cancer in 2014, a chronic myeloid leukemia in 2015 and a 16 mm renal cell carcinoma in 2017. After 27 years, in 2018, his routine follow-up sonography showed incidentally a 37 mm hepatic nodule in segment VII which revealed after percutaneous liver guided biopsy a hepatocellular carcinoma. As no extra hepatic metastasis was noted, segmentectomy was done. The pathological report confirmed a moderately differentiated hepatocellular carcinoma nodule of 50 mm diameter with absence of microvascular invasion and the non-tumoral liver showed histological features of NASH (SAF score: S1A2F3, NAS score: A3F3 and LAFSc:5) with absence of HBsAg and HBcAg. This case emphasizes the importance of long-term close surveillance by imaging of the graft even in the absence of viral recurrence and graft cirrhosis.

• Authors: Nada El-Domiaty, Faouzi Saliba, Mylène Sebagh, Chady Salloum, Eric Vibert, Daniel Azoulay, Jocelyne Hamelin, Daniel Cherqui, René Adam, Didier Samuel
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 21 Issue 5 Pg. 1953-1958 (05 2021) ISSN: 1600-6143 [Electronic] United States
• PMID: 33382179 (Publication Type: Case Reports)
• Copyright: © 2021 The American Society of Transplantation and the American Society of Transplant Surgeons.

Topics

• Adult
• Allografts
• Carcinoma, Hepatocellular (etiology, surgery)
• Humans
• Liver Cirrhosis (etiology)
• Liver Neoplasms (etiology, surgery)
• Liver Transplantation (adverse effects)
• Living Donors
• Male