Adverse Occurrence type:
Tumor was of unknown primary site but presence in liver and donor elevation of Ca19.9 is suspicious for biliary origin. Most recent risk assessment (Council of Europe, 2022): Oesophageal, gastric, pancreatic, liver and biliary cancers diagnosed during donor procurement : These tumours are classified as unacceptable risk. Oesophageal, gastric, pancreatic, liver and biliary cancers in the donor history: Treated tumours of these kinds in the donor history are classified as high risk due to their aggressive behaviour. Risk may decrease for early stages after curative therapy, with recurrence-free time > 5 years and with increasing probability of cure, especially in cases of long-term survivors.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Liver ultrasound of the anastomoses showed a 1.5 cm mass. Biopsy showed a moderately differentiated mucin secreting adenocarcinoma.
Demonstration of imputability or root cause:
Tumor, donor, and recipient DNA was isolated from the parafin embedded liver biopsy, pretransplant liver donor biopsy and explanted liver tissue, respectively. Microsatellite analysis was performed by polymerase chain reaction (PCR) using 5 markers: D5S346, ACTC, D2S123, D18S34, and TP53. The allelic patterns of tumor DNA were identical to those of donor DNA and were distinct from the DNA profile of the recipient.
Suggest new keywords:
Carcinoma of unknown primary site
1. Kakar S, Burgart LJ, Charlton MR, Saito Y, Halling K, Thibodeau SN. Origin of adenocarcinoma in a transplanted liver determined by microsatellite analysis. Hum Pathol. 2002 Apr;33(4):435–6.