Case report: Neuroendocrine carcinoma (2000)

Record number: 
332
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for neuroendocrine tumors (including high grade neuroendocrine carcinomas, low(er) grade neuroendocrine tumors, carcinoid tumors, pheochromocytomas and paragangliomas) (Council of Europe, 2022): Due to their potential for undetected metastasis, high-grade neuro-endocrine carcinomas are an unacceptable risk for organ donation. Insufficient information exists to guide practice for neuro-endocrine tumours, carcinoid tumours, phaeochromocytomas and paragangliomas. In the case of critically ill recipients, these tumours might be acceptable after a careful individual risk–benefit analysis. Neuro-endocrine tumours in the donor history: No data are available from the literature. Due to this and their potential for undetected metastasis, treated high-grade neuro-endocrine neoplasms in the donor history are classified as high risk for organ donation. In the case of a previous history (> 5 years) of neuro-¬endocrine tumours (carcinoid tumours, phaeochromocytomas and paragangliomas) without any kind of disease recurrence or progression, donors should be considered high risk in the absence of sufficient information to guide practice.
Alerting signals, symptoms, evidence of occurrence: 
Elevated creatinine, enlarged left supra-clavicular lymph node and right inguinal swelling in area of allograft. CT showed extensive mediastinal and retroperitoneal lymphadenopathy. A fine needle aspiration of one of the liver nodules demonstrated neuroendochrine carcinoma.
Demonstration of imputability or root cause: 
Sex-mismatched transplant recipients (kidney and liver). Fluorescence in situ hybridization (FISH) analysis was performed on liver core needle biopsy material from the liver transplant patient and on liver fine needle aspiration cytopreparations from the kidney transplant patient. The results for the liver transplant patient were confirmed with microsatellite allelic analysis and with comparative genomic hybridization. In both cases, FISH showed the presence of only X chromosomes within the tumor cells, indicating the donor origin of the neoplasms.
Imputability grade: 
3 Definite/Certain/Proven
Suggest references: 
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