De novo perihilar cholangiocarcinoma arising in the allograft liver 15 years post‐transplantation for biliary atresia

Most primary liver cancers diagnosed in allograft livers are recurrent tumors of the native liver origin, while donor‐derived primary liver cancers are markedly less common. A 21‐year‐old woman who had liver transplantation for post‐Kasai biliary atresia was recently referred for post‐transplant bil...

Full description

Saved in:
Bibliographic Details
Published in:Pathology international 2020-08, Vol.70 (8), p.563-567
Main Authors: Zen, Yoh, Srinivasan, Parthi, Kitagawa, Misa, Suzuki, Koichi, Heneghan, Michael, Prachalias, Andreas
Format: Article
Language:English
Subjects:
Adenocarcinoma
Allografts
Bile
Bile ducts
Biliary atresia
Cancer
Chemotherapy
Cholangiocarcinoma
Cholangitis
Cisplatin
Jaundice
Liver
Liver transplantation
Ostomy
Radiation therapy
Stricture
Transplantation
Transplants & implants
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Most primary liver cancers diagnosed in allograft livers are recurrent tumors of the native liver origin, while donor‐derived primary liver cancers are markedly less common. A 21‐year‐old woman who had liver transplantation for post‐Kasai biliary atresia was recently referred for post‐transplant biliary stricture. Her transplantation was performed at the age of 6 years using the whole liver graft from a 10‐year‐old donor and choledocho‐jejunostomy. The post‐transplant course was uneventful in the first 15 years until she presented with obstructive jaundice. The stricture was located at the level of the hepaticojejunostomy, and required percutaneous transhepatic drainage and bile duct dilatation. She underwent an exploratory laparotomy, which suggested a neoplastic process widely involving the extrahepatic and intrahepatic large bile ducts. The histological examination of the resected extrahepatic bile duct confirmed infiltrating moderately differentiated adenocarcinoma. Molecular tests of multiple short tandem repeat loci confirmed the donor origin of the tumor. After four cycles of chemotherapy with gemicitabine and cisplatin, she is currently on radiotherapy in view of potential re‐transplantation. De novo, post‐transplant cholangiocarcinoma of graft origin is extremely uncommon with only three other cases reported. Two were associated with recurrent primary sclerosing cholangitis, and all had choledocho‐jejunostomy at the time of transplantation.
ISSN:1320-5463
1440-1827
DOI:10.1111/pin.12944