Adenocarcinoma arising in a transplanted pancreas.

Tumor transmission or de novo tumor development in the transplanted organ is a rare event. Appreciation of the organ-specific risk factors for tumor development and careful inspection of the organ at procurement may reduce but not eliminate this complication. We report the first known combined kidney-pancreas recipient who developed adenocarcinoma in the transplanted pancreas. Molecular typing of the tumor by DNA sequencing supports donor derivation of the tumor. Despite cessation of immunosuppression and reconstitution of the recipient's immune response, the patient died from metastatic pancreatic adenocarcinoma. Comparison is made to the reported outcomes after diagnosis of renal cell carcinoma that appeared early after transplantation.