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Post-transplant lymphoproliferative disorder of the cervix
Nimesh P Nagarsheth1, Tamara Kalir, Jamal Rahaman
1Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, 1176 Fifth Avenue, Box 1173, New York, NY 10029-6574, USA. nimesh.nagarsheth@mssm.edu
Background:
Post-transplant lymphoproliferative disorder involving the female genital tract is a rare event.
Case:
A 67-year-old female status post orthotopic liver transplant 5 years previously for hepatitis B and sarcoidosis presented with vaginal bleeding. Endometrial biopsy revealed a high-grade malignant tumor with immunologic marker studies consistent with lymphoma. The patient underwent an exploratory laparotomy, modified radical hysterectomy, bilateral salpingo oophorectomy, bilateral selective pelvic and para-aortic lymphadenectomy, and omentectomy. Final pathology confirmed monomorphic B-cell post-transplantation lymphoproliferative disorder consistent with non-Hodgkin's B cell lymphoma confined to the endocervix and lower uterine segment. She remains recurrence free after 4 years with no adjuvant therapy.
Conclusion:
Post-transplant complications can present in the female reproductive organs. Gynecologic oncologists need to be aware of this disease process when treating patients for gynecologic symptoms after transplant surgery.