Clinical Features of de Novo Lung Neuroendocrine Tumor after Liver Transplantation for Hepatocellular Carcinoma

Objective: To analyze the clinical features of de novo lung neuroendocrine tumor (NET) after liver transplantation (LT) for hepatocellular carcinoma (HCC). Method: Retrospectively reviewed the clinical data of the 1253 patients who underwent LT from 2013 to 2022 in our institute. Result: Out of 1253 recipients of LT 7 patients suffered de novo lung carcinoma, of these 2 patients suffered lung NET accounting for 28.6% (2/7) of de novo lung carcinoma both at extensive stage. New on-set lung lesions and hilar and mediastinal lymphadenopathy were found by imaging tests; and were diagnosed as lung NETs in both patients through pathological examination. The interval between LT and diagnosis of lung NET ranged from 5.9 to 44.7 months. Both patients received cisplatin and etoposide as first-line chemotherapy and achieved partial remission. The progression-free survival period ranged from 1.9 to 2.2 months. Survival after diagnosis of lung NET ranged from 7.0 to 10.9 months. One of the patients tried to cease immunosuppressants during chemotherapy and incurred graft rejection. Conclusion: Lung NET may have a higher proportional incidence of de novo lung carcinoma in LT recipients. Early diagnosis is vital for the treatment of lung NET, while predictive and timely biopsy based on imaging findings is crucial for making an early diagnosis.