Case report: Bone tumor of the scapula in a patient undergoing liver transplantation.

Abstract

De novo malignancies are serious complications in the late postoperative period after liver transplantation. The most common de novo tumors are skin malignancies, posttransplantation lymphoproliferative disorder, tumors of the head and neck, and Kaposi's sarcoma. Such posttransplant de novo malignancies are apparently rarely found in bone. We describe a patient with a low-grade, aggressive fibrous histiocytoma of the scapula. The patient had undergone liver transplantation 6 years earlier. En bloc resection of the tumor and limb salvage was performed. At the 2-year followup the patient had no signs of local recurrence or metastatic spread; the patient had a Musculoskeletal Tumor Society (MSTS) score of 87. A literature review suggests the main predisposing factors to such malignancies are immunosuppression and its length of use. According to the literature, tumors apparently are rare in bone after liver transplantation, with no clearly documented cases. However, in the presence of such a finding, our study might be the first clearly documented case study of this kind of bone tumor. We describe a patient with a bone tumor after liver transplantation. Our literature review suggests liver transplantation and long-term immunosuppression played a role in this patient's tumor.