Concomittant Liver Transplantation and Low Anterior Resection in Patient with Neuroendocrine Tumor and Chronic Hepatitis B Infection

Abstract Aim: The treatment of end-stage liver disease is liver transplantation. There are studies regarding liver transplantation in patients with colorectal cancer and neuroendocrine tumor liver metastasis indicating comparable results with patients who were transplanted for hepatocellular carcinoma. The aim of the present study is to present a case of a patient with Hepatitis B virus related chronic liver disease and rectal neuroendocrine tumor who underwent concomitant living donor liver transplantation and low anterior resection. Case report: The patients was a 62 years old male patient with hepatitis B virus related end-stage liver failure and a rectal neuroendocrine tumor determined during colonoscopy surveillance. Model for end stage liver disease score was 21 and had two episodes of life-threatening variceal bleeding. We performed living donor liver transplantation and low anterior resection to the patient. Currently patient is doing well 2 years after the operation. Conclusion: Our case is the first in literature showing concomitant liver transplantation for hepatitis B virus related liver failure and rectal resection for neuroendocrine tumor. These procedures can be performed synchronously provided that the etiology of liver failure is unrelated to neuroendocrine tumor and the primary tumor has favorable tumor biologic characteristics. We reviewed the English literature, we did not find any case who underwent rectal NET surgery and HBV-related liver transplantation in the same operation. We wanted to present this first case in the literature.