Surgical Management of Gastric Cancer With a History of Liver Transplantation: Case Report

Rationale The number of solid organ transplants has increased worldwide. Liver transplantation is an effective treatment of end-stage liver disease and some selected malignancies. The increased life expectancy has resulted in an increase in comorbidities after transplantation, including de novo malignancies. Gastric cancer after a liver transplant is not prevalent. In this case report, we report the case of a patient who presented with gastric cancer after liver transplantation. Patient concerns Our patient is a 62-year-old male patient who received liver transplantation three years ago. About 36 months after transplantation, the patient presented with upper gastrointestinal bleeding. Diagnosis A decision was taken to do upper gastrointestinal endoscopy, which revealed a 5-centimeter tumour on the greater curvature. A biopsy of the tumour was done, and the histology revealed Adenocarcinoma. Interventions The patient underwent open total gastrectomy with D2 dissection and esophagojejunal anastomosis. Outcomes The postoperative period of the patient was uneventful, and the patient was discharged after 10 days. Lessons The mainstay of treatment of gastric cancer in recipients of liver transplantation is gastrectomy with D2 dissection. Prompt diagnosis and surgical management are required to treat these patients, and during the perioperative period, the immunosuppressive medications should be continued to prevent graft rejection.