Focus on Very Late Hepatocellular Carcinoma Recurring After Liver Transplantation: A Case Report and Literature Review

Federica Invernizzi, Umberto Maggi, Stefano Mazza, Marco Baia, Mario Nosotti, Paolo Mendogni, Paolo Muiesan, Aldo Cannata, Massimo Iavarone, Francesco Damarco, Pietro Lampertico, Maria Francesca Donato, Giorgio Rossi

Research output: Contribution to journalArticle


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.

Original languageEnglish
Pages (from-to)2998-3000
JournalTransplantation Proceedings
Issue number9
Publication statusPublished - 2019


ASJC Scopus subject areas

  • Surgery
  • Transplantation

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