Rectal Carcinoid Tumor With Liver Metastases Treated by Local Excision and Orthotopic Liver Transplant With Long-term Follow-up

• Published in: Experimental and clinical transplantation Vol. 16; no. 4; pp. 506 - 510
• Main Authors: Vennarecci, Giovanni, Mascianà, Gianluca, de Werra, Edoardo, Guglielmo, Nicola, Levi Sandri, Giovanni Battista, Coluzzi, Mariagrazia, Ettorre, Giuseppe Maria
• Format: Journal Article
• Language: English
• Published: Turkey Başkent Üniversitesi 01.08.2018
• Subjects: Carcinoid Tumor - diagnostic imaging; Carcinoid Tumor - secondary; Carcinoid Tumor - surgery; Disease Progression; Fatal Outcome; Humans; Intestinal Neoplasms - diagnostic imaging; Intestinal Neoplasms - secondary; Intestinal Neoplasms - surgery; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Liver Transplantation; Male; Middle Aged; Rectal Neoplasms - diagnostic imaging; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Time Factors; Tıp; Tomography, X-Ray Computed; Treatment Outcome; Ankara; Türkiye; Liver transplant; Neuroendocrine tumor; Liver metastases
• ISSN: 1304-0855; 2146-8427
• DOI: 10.6002/ect.2016.0016

In patients affected by unresectable liver metastases from neuroendocrine tumor, liver transplant represents currently the only realistic chance for cure. The first attempt to establish selection criteria for liver transplant in patients affected by neuroendocrine tumor liver metastases was made by Mazzaferro and associates in 2007. We report the case of a 46-year-old man who came to our institution in 2006 with right upper quadrant abdominal pain. Diagnosis of rectal neuroendocrine tumor with bilobar liver nodules was made; the patient underwent transanal local resection. A liver biopsy confirmed the metastatic nature of the hepatic lesion, showing a low-grade neuroendocrine tumor (G1, proliferation index Ki-67 <2%). The patient underwent 2 sessions of transarterial chemoembolization that resulted in stable disease. Afterward, the patient underwent a liver transplant, using the piggyback technique without a venous-venous bypass. His postoperative course was uneventful. The patient has been disease-free for 3 years. Posttransplant treatment has played a key role in increasing the overall survival of the patient and assuring him a good quality of life. He died 9 years (102 mo) after liver transplant.