Hepatic Angiosarcoma Post-Renal Transplantation: A Case Report.

Area of Science:

• Oncology
• Transplantation Medicine
• Hepatology

Background:

• Kidney transplantation recipients have a higher risk of developing various cancers, including skin cancer, Kaposi's sarcoma, oral cancer, and non-Hodgkin lymphoma, often linked to DNA damage and oncogenic viruses.
• Immunosuppressive therapy, essential for graft survival post-kidney transplantation, can contribute to the increased cancer risk.

Observation:

• A 57-year-old female kidney transplant recipient, maintained on tacrolimus, mycophenolate sodium, and everolimus, presented with a 2-week history of gastrointestinal symptoms including diarrhea, epigastric pain, abdominal fullness, tea-colored urine, and constipation.
• Despite regular annual abdominal ultrasounds showing no abnormalities, a subsequent abdominal CT scan revealed multiple hepatic tumors with engorged vasculatures and mild hemoperitoneum.
• A liver biopsy confirmed the histopathological diagnosis of angiosarcoma.

Findings:

• This report details an uncommon case of liver angiosarcoma occurring 8 years after kidney transplantation.
• The patient experienced rapid disease progression, leading to multiple organ failure within one month of diagnosis and treatment initiation.

Implications:

• The occurrence of rare post-transplant malignancies like liver angiosarcoma underscores the importance of comprehensive surveillance in kidney transplant recipients.
• Regular screening and prompt investigation of any new symptoms are crucial for early detection and management of potential post-transplant cancers.
• This case emphasizes the need for ongoing research into the specific oncogenic pathways and risk factors associated with diverse malignancies following solid organ transplantation.