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• W2914148368 abstract "Introduction Liver transplant recipients of hepatocellular carcinoma (HCC) are at increased risk of either recurrent HCC or de novo malignancies. HCC recurs early, usually within 1-2 years post-transplant. Delayed recurrence (>5 years) is rare. Liver is the primary site of recurrence in most reported cases. We report an unusual case of delayed HCC recurrence, approximately 8 year following liver transplant. Case Report A 74-year-old Hispanic male with past medical history of Hepatitis C virus (HCV) related cirrhosis and HCC (within Milan criteria) received an orthotropic liver transplant in 2009. His post-transplant course remained uneventful until early year 2017. Liver biopsy obtained during his laparoscopic incisional hernia repair three years before was essentially normal. His most recent magnetic resonance imaging (MRI) study did not reveal any sign of chronic liver disease or cirrhosis. He was maintained on tacrolimus 0.5 mg twice a day. He was seen in the emergency department at our facility for difficulty in urination and new onset constipation. He also complained of lower back pain and decreased strength in the right lower extremity. His physical examination was normal except for decreased rectal tone and 4/5 strength in the right lower extremity. He was considered to have lower spinal cord compression. Computer tomography (CT) scan and MRI showed an enhancing 5.4 cm soft tissue mass involving the S3 and S4 vertebral bodies extending into the bilateral S3 and S4 neural foramen as well as spinal canal (Figure 1). The rest of spinal cord was normal. CT scan guided biopsy of this lesion was positive for metastatic HCC. His alpha feto-protein was less than 5ng/ml. He received fifteen days of radiation treatments with an excellent recovery his bowel and bladder function. He was then referred to oncology and is under consideration for sorafinib.Figure: HCC involving S3-S4.Discussion and conclusion HCC recurrence post liver transplantation depends on the primary tumor size, differentiation, microvascular invasion and tumor biomarkers. This case is unique from other reported cases as there was no tumor recurrence in the liver itself. It presented clinically as spinal cord compression eight years post-transplant. There was no evidence of any lesion or any signs of liver cirrhosis in the graft." @default.
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• W2914148368 date "2017-10-01" @default.
• W2914148368 modified "2023-10-01" @default.
• W2914148368 title "Coming Back With a Vengeance: Very Late Recurrence of Hepatocellular Cancer in a Liver Transplant Recipient Presenting as Spinal Cord Compression" @default.
• W2914148368 doi "https://doi.org/10.14309/00000434-201710001-02291" @default.
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