Abstract
BackgroundApart from Kasai’s procedure, liver transplantation (LTx) has dramatically improved the outcome of children with biliary atresia (BA). However, de novo malignancy has been reported to be one of the major causes of late mortality after LTx among adults. We report a rare case of de novo gastric cancer developing after LTx for BA received during childhood.Case presentationA 21-year-old male patient who had undergone LTx for BA at age 2 years occasionally visited our outpatient clinic due to symptoms of epigastric pain and dysphagia. Endoscopic examination and computed tomography revealed advanced gastric cancer at the gastroesophageal junction with multiple liver metastases. Despite systemic chemotherapy, the disease progressed, resulting in patient’s death 2 years after the diagnosis.ConclusionsDe novo malignancy in the absence of post-transplant lymphoproliferative disease is rare in pediatric patients who received LTx. To the best of our knowledge, no report has been available on the development of gastric cancer after LTx for BA during childhood. Primary physicians should therefore establish a follow-up plan for patients receiving LTx for BA considering the potential for the development of de novo malignancy, including gastric cancer, despite its rarity.
Highlights
Apart from Kasai’s procedure, liver transplantation (LTx) has dramatically improved the outcome of children with biliary atresia (BA)
De novo malignancy in the absence of post-transplant lymphoproliferative disease is rare in pediatric patients who received Liver transplantation (LTx)
Primary physicians should establish a follow-up plan for patients receiving LTx for BA considering the potential for the development of de novo malignancy, including gastric cancer, despite its rarity
Summary
We herein detail our experience with a rare case of de novo gastric cancer developing after LTx received during childhood for BA. Primary physicians should therefore schedule follow-up plans considering the potential for patients receiving LTx for BA to develop de novo malignancy, including gastric cancer, despite its rarity. Abbreviations LTx: Liver transplantation; BA: Biliary atresia; PTLD: Post-transplant lymphoproliferative disease; HER-2: Human epidermal growth factor type 2; EBV: Epstein–Barr virus; EBER-ISH: Epstein–Barr virus-encoded small RNA in situ hybridization.
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