Delayed recurrence of hepatocellular carcinoma after liver transplantation: Detection of origin by chromosomal analysis

We report on a 41-year-old man undergoing liver transplantation for chronic hepatitis C who presented 26 months later with hepatocellular carcinoma. N o evidence of hepatocellular carcinoma could be found in the native liver, although features of small cell dysplasia were prominent. Although he had r ecurrent hepatitis C, the transplanted liver was not cirrhotic. Chromosomal analysis was used to resolve whether this was a de novo tumor or a recurre nce of an unsuspected tumor present at the time of transplantation. This ma le patient had received a liver from a female donor, and in situ hybridizat ion for the Y chromosome showed reactivity in the tumor but not in surround ing nontumorous liver. Thus, this is an example of the use of chromosomal a nalysis to resolve the origin of a tumor occurring in the transplant settin g.