Effects of transplantation-related immunosuppression on co-existent neuroendocrine tumours.
Abstract
Background: Here we detail our experience of managing patients found to have a neuroendocrine neoplasm (NEN) whilst on immunosuppression for a transplanted organ. Aim: We aimed to quantify the behaviour of NENs under solid-organ transplant-related immunosuppression. Design: This was an observational, retrospective case series. Methods: Ten patients were identified from a prospectively kept database. Three were excluded. Results: Four patients received a liver, two a kidney, and one a heart transplant. All but one received calcineurin-based immunosuppression. NENs were found in five patients post-transplant: one had surgery for transverse colonic neuroendocrine carcinoma NEC (pT4N1M0, Ki67 60%), was cancer-free after four years; one had cold biopsy of duodenal NEN (pT1N0M0, Ki67 2%), cancer-free at four months; one 7 mm pancreatic NEN (pT1N0M0), untreated and stable for seven years; one small-bowel NEN with mesenteric metastasis (pTxNxM1), alive four years after diagnosis; and one untreated small-bowel NEN with mesenteric metastasis, stable at 1 year after liver transplantation. Two NENs were discovered pre-transplant, one pancreatic NEN (pT1N0M0, Ki67 5%), remains untreated and stable at three years. One gastric NEN (type 3, pT1bN0M0, Ki67 2%) remains stable without treatment for two years. Conclusions: NENs demonstrate indolent behaviour in the presence of transplant-related immunosuppression.Citation
Shah HA, Faulkes R, Coldham C, Shetty S, Shah T. Effects of transplantation-related immunosuppression on co-existent neuroendocrine tumours. QJM. 2022 Oct 25;115(10):661-664. doi: 10.1093/qjmed/hcac036Type
ArticleAdditional Links
https://academic.oup.com/qjmedPMID
35143660Publisher
Oxford University Pressae974a485f413a2113503eed53cd6c53
10.1093/qjmed/hcac036