Development of donor-derived prostate cancer in a recipient following orthotopic heart transplantation
E. Loh, F. J. Couch, C. Hendricksen, L. Farid, P. F. Kelly, M. A. Acker, J. E. Tomaszewski, S. B. Malkowicz and B. L. Weber
Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA.
OBJECTIVE: To report the development of metastatic prostate cancer in a
heart transplant recipient without a primary focus in the recipient
prostate gland; to present genetic evidence suggesting transplantation of
the malignancy from the donor. DESIGN: Histological analysis of donor
prostate and recipient prostate and rib. Molecular genetic analysis of
prostate and kidney tissue from the donor and peripheral blood leukocytes
and rib tissue from the transplant recipient. SETTING: University of
Pennsylvania Medical Center. RESULTS: Multiple biopsies of recipient
prostate were negative for malignancy but recipient rib contained prostatic
adenocarcinoma with osteoblastic bone response. Molecular genetic analysis
of recipient rib specimen, which contained both histologically normal and
neoplastic cells, was shown to contain a combination of alleles from the
donor and recipient at 4 loci. CONCLUSION: Although this is a single case
report of an uncommon event, genotyping of polymorphic dinucleotide repeat
elements from 4 different chromosomal regions provides strong evidence that
the tumor cells arose from donor tissue and were transplanted along with
the cardiac allograft.
