Version June 2024
| Tumor | Comments |
| Squamous cell and basal cell carcinomas | Squamous cell carcinomas are more frequent than basal cell carcinomas, in contrast to the non-transplantation context where basal cell carcinomas are five times more frequent than squamous cell carcinomas. The risk increases with the length of the immunosuppression. After 15 years, they can be found in more than 50 percent of the recipients of a liver transplantation, particularly in regions exposed to sunlight. Regular use of sunscreens may prevent the development of squamous cell carcinoma and to a lesser degree basal cell carcinoma[1]. The use of topical diclofenac 3 percent gel may improve post-liver transplantation actinic keratosis and decrease the risk of squamous cell carcinoma[2]. These cancers are also frequent in the anogenital region, where they may indicate the presence of another pathogen, human papilloma virus. They are often multiple and aggressive with rapid recurrence after excision, early metastases, or coexistence with a sarcomatous component. |
| Cutaneous lymphomas | Primary lymphomas of the skin are rare after liver transplantation. When present, they appear as nodules and tumors that are necrotic or ulcerative, more often on the face. They typically occur about three years after transplantation and are a sign of an infection with Epstein-Barr virus and/or strong immunosuppression. T-cell lymphoma/Sézary syndrome is rare after liver transplantation[3]. |
| Melanomas | Melanomas are 2.5 to 4 times more frequent after liver transplantation than in a non-transplanted population[4]. A history of a melanoma before the transplantation is a risk factor for a subsequent melanoma. Melanomas can appear de novo after transplantation (after a mean time of five years), be a recurrence or, rarely, be transferred by the graft. Remission has been described in the setting of kidney transplantation after removal of the graft. |
| Kaposi's sarcoma | The risk of developing a Kaposi's sarcoma after liver transplantation increases 400 to 500 times. The lesions can appear in the first six months following the transplantation. Late presentations are also possible (more than 10 years after transplantation). Infection with herpes virus 8 and immunosuppression have a pathogenic role. The lesions are limited to the skin in 50 percent of the cases. They appear as violaceous plaques or nodules accompanied by lymphedema. They are most frequently seen on the inferior extremities but can occur anywhere. They may display Koebner's phenomenon (occur in areas of trauma). The evolution is usually indolent, but fulminant forms have been reported. |
| Merkel's cell tumors | The incidence of these tumors, which have been associated with the Merkel cell polyoma virus, is increased after liver transplantation. The clinical presentation is usually a firm and inflammatory nodule. These tumors can be aggressive with local diffusion, metastasis, and rapid recurrence after excision. |
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