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Case Report: Primary De Novo Sarcoma In Transplant Pancreas Allograft
S Nagaraju1, S J Grethlein2, S Vaishnav3
1Division of Transplantation, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
Transplantation Proceedings
|December 5, 2017
Summary
A rare soft tissue sarcoma developed in a pancreas transplant allograft, likely linked to polyomavirus and originating from the recipient. Surgical removal and close monitoring are crucial for managing this unusual post-transplant malignancy.
Area of Science:
- Oncology
- Transplantation Medicine
- Virology
Background:
- Malignancies post-transplantation are often virally mediated and recipient-derived.
- Donor-derived neoplasms appear early; recipient-origin tumors manifest years later.
- Sarcomas are rare cancers with largely unknown etiology, occasionally linked to viruses or radiation.
Observation:
- A patient with a history of type 1 diabetes and pancreas transplant developed a small bowel obstruction.
- Imaging revealed a mass in the pancreas allograft head, necessitating surgical removal (pancreatectomy).
- Histopathology identified a stage III high-grade spindle cell sarcoma, positive for polyomavirus.
Findings:
- This case represents a rare instance of soft tissue sarcoma arising within a pancreas allograft.
- The sarcoma was likely of recipient origin and associated with polyomavirus infection.
- The patient underwent successful allograft pancreatectomy and showed no recurrence at 489 days post-operation.
Implications:
- Soft tissue sarcomas can occur in pancreas allografts, a previously unreported phenomenon.
- Early detection and surgical excision are vital for favorable outcomes in allograft sarcomas.
- Close monitoring for recurrence is essential following treatment for sarcoma in transplant recipients.
