Devastating fast-growing lung cancer after single lung transplantation

Abstract

Patients receiving lung transplantation are at increasing risk for the development of cancer due to the administration of immunosuppressive drugs. We hereby report the case of a patient with a devastating fast-growing lung cancer after single lung transplantation for pulmonary fibrosis.

Management of Native Lung Malignancy in a Lung Transplant Recipient

“…Nonsurgical management is tailored to individual patient characteristics, and there are limited data on the optimal treatment regimen. 4,13 Typically, carboplatin-based chemotherapy can interfere with immunosuppressive regimens and increase the risk of the development of bronchiolitis obliterans syndrome. 4 Radiation is generally reserved for nonresectable malignancies within the native lung and any cancer within the transplanted lung.…”

“…2 Chronic immunosuppression is thought to contribute to the increased risk of lung cancer. 13 Treatment of lung cancer within transplanted patients can be complicated. Lung cancer within the native lung can be successfully treated with resection, provided there are favorable tumor characteristics and acceptable pulmonary function.…”

Factors affecting complications development and mortality after single lung transplant

“…On the other side, the graft’s rigorous assessment in this direction is also mandatory to lower the chance of any early (subclinical) malignant lesions being transplanted to the recipient. An example of the aggressive nature of secondary lung cancers after SLT is provided by Gherzi et al [ 104 ], who reported a 62-year-old woman with fast-progressing adenocarcinoma of the native lung only 15 mo after transplantation for pulmonary fibrosis. Due to multiple graft rejection episodes, the patient was treated with intensive immunosuppression in the post-transplant period.…”