Successfully-treated Advanced Bile Duct Cancer of Donor Origin After Hematopoietic Stem Cell Transplantation by Pancreaticoduodenectomy: A Case Report

Secondary malignancies are one of the late complications observed in long-term survivors of allogeneic hematopoietic stem cell transplantation (HSCT). However, reports on secondary non-hematopoietic solid tumors derived from donor cells is extremely rare. We herein report a successfully-treated case of advanced bile duct cancer of donor-origin after allogeneic HSCT. A 44-year-old man was diagnosed with acute myeloid leukemia. When he achieved the third complete response, allogeneic hematopoietic stem cells of one-mismatch female donor were transplanted at the age of 50 years. Post-transplant acute and chronic graft-versus-host disease was treated by increased immunosuppression. At the age of 59, the patient was diagnosed with lower bile duct cancer and underwent pancreaticoduodenectomy with lymph node dissection. Pathological findings revealed a well-differentiated adenocarcinoma of the bile duct. Additional fluorescence in situ hybridization analysis revealed female patterns of the tumor cells, which suggested that the tumor cells originated from the donor. The patient had a satisfactory recovery, and received adjuvant chemotherapy with S-1. He remains well with no evidence of tumor recurrence as of one year after resection.