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2024 ; 16
(7
): 2343-2350
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Colon signet-ring cell carcinoma with chylous ascites caused by
immunosuppressants following liver transplantation: A case report
#MMPMID39087099
Li Y
; Tai Y
; Wu H
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2343-2350
PMID39087099
show ga
BACKGROUND: Chylous ascites is caused by disruption of the lymphatic system,
which is characterized by the accumulation of a turbid fluid containing high
levels of triglycerides within the abdominal cavity. The two most common causes
are cirrhosis and tuberculosis, and colon signer ring cell carcinoma (SRCC) due
to the use of immunosuppressants is extremely rare in cirrhotic patients after
liver transplantation, making it prone to misdiagnosis and missed diagnosis. CASE
SUMMARY: A 52-year-old man who underwent liver transplantation and was
administered with immunosuppressants for 8 months was admitted with a 3-month
history of progressive abdominal distention. Initially, based on
lymphoscintigraphy and lymphangiography, lymphatic obstruction was considered,
and cystellar chyli decompression with band lysis and external membrane stripping
of the lymphatic duct was performed. However, his abdominal distention was
persistent without resolution. Abdominal paracentesis revealed allogenic cells in
the ascites, and immunohistochemistry analysis revealed adenocarcinoma cells with
phenotypic features suggestive of a gastrointestinal origin. Gastrointestinal
endoscopy was performed, and biopsy showed atypical signet ring cells in the
ileocecal valve. The patient eventually died after a three-month follow-up due to
progression of the tumor. CONCLUSION: Colon SRCC, caused by immunosuppressants,
is an unusual but un-neglected cause of chylous ascites.
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