A case of newly developed lung adenocarcinoma following liver transplantation for hepatocellular carcinoma

doi:10.3969/j.issn.1004-583X.2025.12.010

Abstract

Abstract:

Objective To explore the clinical characteristics，diagnostic methods and treatment challenges of newly developed lung adenocarcinoma in liver cancerpatients after liver transplantation，thus providing references for the diagnosis and treatment of such special cases in clinical practice. Methods A retrospective analysis was conducted on the clinical data of a 68-year-old liver cancer patient with newly developed lung adenocarcinoma after liver transplantation，including medical history，symptoms and signs，diagnostic methods and treatment process. Results The patient was diagnosed with lung adenocarcinoma by percutaneous lung biopsy. Lung cancer-related genes and programmed death ligand-1 （PD-L1） were all negative. After chemotherapy，a severe increase in liver transaminase forced to the termination of chemotherapy. The lung tumor continued to progress，leading to respiratory failure that was required for non-invasive ventilator-assisted ventilation. Conclusion Long-term immunosuppressive therapy after liver transplantation for liver cancer may increase the risk of new malignant tumors. Lung adenocarcinoma in such patients has an insidious onset and lacks typical clinical manifestations，and the diagnosis relies on pathological examination. Poor tolerance to chemotherapy is the main difficulty in its treatment. Clinically，individualized diagnosis and treatment plans should be formulated based on the basic post-transplantation conditions. While undergoing anti-tumor treatment，attention should also be paid to the protection of organ functions.

Key words: liver transplantation, lung cancer, immunotherapeutic agents, immune escape

CLC Number:

R657.3

Wang Yuanyuan, Zhao Zhifang, Zhao Yunxia, He Yang, Zhang Qing. A case of newly developed lung adenocarcinoma following liver transplantation for hepatocellular carcinoma[J]. Clinical Focus, 2025, 40(12): 1108-1112.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.12.010

https://www.lchc.cn/EN/Y2025/V40/I12/1108

Figures/Tables 3

Fig.1 Chest CT manifestations of the patient on admission a-c. Multiple nodules with cavities in both lungs，and a larger nodule in the right lower lung； d. Enlarged mediastinal lymph nodes； e. Solid nodule in the right lower lung； f. Percutaneous lung puncture of a larger nodule in the right lower lung in the prone position

Fig.2 Pathological results of lung biopsy： Mucinous adenocarcinoma （H&E×200）

Fig.3 Chest CT reexamination of the patient 2 months after discharge a-c. Multiple nodules with enlarged cavities in both lungs，new pleural effusion，and a significantly enlarged mass in the right lower lung； d-f. Increased and enlarged solid masses with new onset of pleural effusion in corresponsive lung window and mediastinal window of both lungs

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