tacrolimus and Conjunctival-Neoplasms

Kaposi sarcoma (KS) is the most common tumor in patients with human immunodeficiency virus (HIV), and its frequency is increasing after organ transplantation in HIV-negative patients. A 28-year-old woman had preemptive kidney transplantation from her 48-year-old mother. In the postoperative ninth month, an exophytic mass was found in the upper medial conjunctiva of the right eye. The lesion was excised under local anesthesia, and cryotherapy was applied to the surgical area. The biopsy result was reported as KS. Treatment with tacrolimus was switched to everolimus (EVO), but EVO was discontinued because of pneumonitis. The patient was followed without any recurrences after the excision of the conjunctival lesion. No local or systemic recurrence was observed in the 14th month after surgical excision and local cryotherapy. Local treatment and the reduction of immunosuppressive therapy may be effective in the treatment of conjunctival KS.

Topics: Adult; Conjunctival Neoplasms; Everolimus; Female; HIV Infections; Humans; Immunocompromised Host; Immunosuppression Therapy; Immunosuppressive Agents; Kidney Transplantation; Sarcoma, Kaposi; Tacrolimus

To report a case of local transmission of invasive lobular carcinoma from a donor to a recipient in a keratolimbal allograft after cessation of systemic immunosuppressive therapy.. This is a case report including the clinicopathologic findings. Sections of the donor breast tumor and recipient conjunctival lesions were stained with hematoxylin and eosin. Immunohistochemical studies were performed using pancytokeratin, CK7, CK20, CAM 5.2, CD138, TTF1, estrogen receptor, progesterone receptor, GATA-3, GCDFP-15, and mammaglobin. Polymerase chain reaction-based DNA profiling of tumor cells was performed.. Histopathologic examination revealed an infiltrate of atypical cells with large hyperchromatic nuclei consistent with carcinoma. Immunohistochemical analysis showed pancytokeratin, CK7, CAM 5.2, GATA-3, and estrogen receptor positivity and progesterone receptor absence, consistent with the previously determined phenotype of the donor's breast carcinoma. Results of polymerase chain reaction analysis were also consistent with the donor's tumor. After reduced dosing of tacrolimus and mycophenolate mofetil, 2 limbal tumors occurred in the recipient. The immunosuppressive treatment had been stopped completely before the appearance of the third lesion. The recipient had no history of malignancy, and she had routine screenings for breast cancer.. We report a case of donor-derived breast carcinoma in a keratolimbal allograft recipient. The grafted tissue harbored donor-derived tumor cells for more than 4 years after surgery even after systemic immunosuppression was discontinued. Although no similar reports of tumor transfer could be found in the literature, this case suggests the need for increased stringency in donor selection and heightened surveillance for such tumor transmission.

Topics: Aged; Allografts; Biomarkers; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Lobular; Conjunctival Neoplasms; Corneal Diseases; DNA Fingerprinting; Female; GATA3 Transcription Factor; Humans; Immunohistochemistry; Immunosuppressive Agents; Keratin-7; Keratins; Limbus Corneae; Mycophenolic Acid; Polymerase Chain Reaction; Receptors, Estrogen; Stem Cell Transplantation; Tacrolimus; Tissue Donors

Topics: Aged; Antineoplastic Agents; Bone Marrow Transplantation; Carcinoma, Squamous Cell; Combined Modality Therapy; Conjunctival Neoplasms; Cryotherapy; Graft vs Host Disease; Humans; Immunosuppressive Agents; Interferon alpha-2; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Tacrolimus; Transplantation, Homologous

To report a case of conjunctival intraepithelial neoplasia in a patient treated with tacrolimus after liver transplantation for hepatic carcinoma.. Description of the initial clinical presentation of a patient, tumor management, and 15-month follow-up.. A 70-year-old man presented with a conjunctival intraepithelial neoplasia that developed on the site of a preexisting pterygium. After total surgical removal and additional application of mitomycin, local tumor control was achieved.. We describe a case of intraepithelial conjunctival neoplasia in a patient treated with systemic tacrolimus. Local tumor control was achieved at 15 months after appropriate surgical management.

Topics: Aged; Antibiotics, Antineoplastic; Carcinoma in Situ; Combined Modality Therapy; Conjunctival Neoplasms; Humans; Immunosuppressive Agents; Liver Neoplasms; Liver Transplantation; Male; Mitomycin; Tacrolimus