TY - JOUR
T1 - Focus on Very Late Hepatocellular Carcinoma Recurring After Liver Transplantation
T2 - A Case Report and Literature Review
AU - Invernizzi, Federica
AU - Maggi, Umberto
AU - Mazza, Stefano
AU - Baia, Marco
AU - Nosotti, Mario
AU - Mendogni, Paolo
AU - Muiesan, Paolo
AU - Cannata, Aldo
AU - Iavarone, Massimo
AU - Damarco, Francesco
AU - Lampertico, Pietro
AU - Donato, Maria Francesca
AU - Rossi, Giorgio
PY - 2019
Y1 - 2019
N2 - Hepatocellular carcinoma (HCC) recurring after liver transplantation (LT) is a major clinical concern, occurring in up to 20% and being the most frequent cause of death in this setting. Usually recurrence occurs within the first 2 years, whereas late and very late recurrences are rare. We report a 71-year-old woman with HCC recurrence after 25 years from LT, an event never reported before. Diagnosis was achieved with a progressive increase of alpha-fetoprotein (AFP) followed by a computed tomography scan, showing a mediastinal, upper diaphragmatic, right paracaval mass of 5 cm in size. The lesion was treated with a surgical approach involving a multidisciplinary team including hepatobiliary, thoracic, and cardiovascular surgeons. A sternotomy and mass removal was performed without the need of an extracorporeal bypass. A complete resection of the tumor was achieved, with a drop in AFP and without signs of recurrence after 1-year follow up. In conclusion, the possibility of late HCC recurrences after LT, despite being rare, underlines the need of a standardized, cost-benefit, optimal strategy of a long-term surveillance. From a surgical point of view, our case is unusual for the site and the character of the lesion, and for the absence of the need of an extracorporeal bypass during the operation.
AB - Hepatocellular carcinoma (HCC) recurring after liver transplantation (LT) is a major clinical concern, occurring in up to 20% and being the most frequent cause of death in this setting. Usually recurrence occurs within the first 2 years, whereas late and very late recurrences are rare. We report a 71-year-old woman with HCC recurrence after 25 years from LT, an event never reported before. Diagnosis was achieved with a progressive increase of alpha-fetoprotein (AFP) followed by a computed tomography scan, showing a mediastinal, upper diaphragmatic, right paracaval mass of 5 cm in size. The lesion was treated with a surgical approach involving a multidisciplinary team including hepatobiliary, thoracic, and cardiovascular surgeons. A sternotomy and mass removal was performed without the need of an extracorporeal bypass. A complete resection of the tumor was achieved, with a drop in AFP and without signs of recurrence after 1-year follow up. In conclusion, the possibility of late HCC recurrences after LT, despite being rare, underlines the need of a standardized, cost-benefit, optimal strategy of a long-term surveillance. From a surgical point of view, our case is unusual for the site and the character of the lesion, and for the absence of the need of an extracorporeal bypass during the operation.
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U2 - 10.1016/j.transproceed.2019.04.095
DO - 10.1016/j.transproceed.2019.04.095
M3 - Article
AN - SCOPUS:85073072885
VL - 51
SP - 2998
EP - 3000
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 9
ER -