【Introduction】 The substantial improvement of patient survival after organ transplantation leads to frequent occurrence of de novo malignancy during the long-term follow-up period. Among such cases, however, one has rarely been reported for pancreatic cancer. Herein, we report two cases of de novo pancreatic cancer after living donor liver transplantation (LDLT).
【Case 1】 A female in her 60s who underwent LDLT at 55 years of age due to alcoholic liver cirrhosis was diagnosed with asymptomatic diabetes mellitus 4 years postoperatively. A month later, a CT scan revealed pancreatic cancer with multiple liver metastasis; no tumor had been detected by CT performed 3 months earlier as part of an annual systemic work-up. The main lesion and liver metastasis was quite rapidly exacerbated despite aggressive chemotherapies. She passed away 4 months after the diagnosis.
【Case 2】 A 60-year-old male who underwent LDLT for decompensated liver cirrhosis type C at the age of 53 exhibited a rapid deterioration of glycemic control at 13 years post-LDLT. Pancreatic cancer without distant metastasis was detected by CT examination. Distal pancreatectomy was performed one month after the diagnosis. Histopathological examination revealed a pancreatic cancer with serosal and retroperitoneal invasions and adjacent lymph node metastasis. Peritoneal dissemination occurred 2 months after the operation, and the patient died 3 months after the distal pancreatectomy.
【Conclusion】 De novo pancreatic cancer is a rare complication after liver transplantation. However, the lesion evolves quite rapidly and the patient with this disease dies within short time period. An early detection based on a clinical sign such as hyperglycemia rather than annual systemic work-up is mandatory for a better outcome. Heavy smoking and/or drinking history may contribute the occurrence of post-transplant pancreatic cancer.
