Transplanted corneal graft with metastatic cholangiocarcinoma to the donor eye

OBJECTIVES: To report a case of corneal transplantation from a donor died of cholangiocarcinoma with metastasis to the eye. METHODS: A patient with limbal dermoid received corneal transplant from a donor died of cholangiocarcinoma. Pathologic examination of the remaining donor limbal tissue revealed metastasis of tumor to the limbal vessels. Prompt exchange of the graft was performed. Before the second corneal transplantation, the surrounding tissue of the recipient bed was excised and sent for histopathologic examination. RESULTS: No tumor transmission was noted surrounding the recipient bed. The second graft remained clear and the patient remained cancer free after regular examination for over a year. CONCLUSIONS: This is the first case to report that cholangiocarcinoma can metastasize to the corneal limbus. To avoid transmission of malignancies from the donor to the recipient, we suggest that donor tissue with history of malignancy should not be used for limbal allografting, and that frozen-section examination of donor limbal tissue is recommended before the transplantation.