Urgent thyroidectomy in the immediate post-lung transplant period

Area of Science:

• Oncology
• Transplant Surgery
• Immunosuppression

Background:

• Solid organ transplant guidelines typically require a 2-5 year cancer-free interval.
• This interval aims to minimize malignancy recurrence under immunosuppression.
• Meeting these timelines can be challenging for patients with severe comorbidities.

Observation:

• A patient with end-stage lung disease had a thyroid nodule with intermediate-high malignancy risk.
• Her respiratory status made meeting the standard cancer-free interval unlikely.
• A multidisciplinary team approved bilateral lung transplantation before thyroidectomy.

Findings:

• The patient underwent lung transplantation, followed by immediate postoperative thyroidectomy due to malignancy concerns.
• This represents a rare case of non-emergent oncologic surgery in the immediate post-transplant period.
• The case underscores the feasibility of transplanting patients with concurrent, treatable malignancies.

Implications:

• This case supports flexible transplant eligibility criteria for patients with malignancy.
• It highlights the need for individualized, multidisciplinary decision-making in transplant oncology.
• Further research into managing transplant candidates with active or recent cancer is warranted.