Surgeon catches CANCER from patient in first-of-its-kind case
A doctor operating on a cancer patient accidentally “transplanted” the disease into himself, which would be a unique event.
A 32-year-old man from Germany was diagnosed with a rare form of cancer and had a tumor removed from his abdomen.
During the operation, the doctor who performed the procedure accidentally cut his hand, but the wound was immediately disinfected and bandaged.
However, five months later, the 53-year-old surgeon noticed a small lump developing where he had injured himself months earlier and sought help.
The lump turned out to be a malignant tumor and tests showed that it was genetically identical to the cancer his former patient was suffering from.
This led the medical team treating him to conclude that he had contracted the cancer when tumor cells entered the cut on his hand.
The authors of the case report called this a common situation because in a traditional transplant the body mounts an immune response and rejects all foreign tissue, and they expected the same in the doctor’s case.
However, given the development and growth of the tumor, this suggests that the surgeon’s body had an “ineffective anti-tumor immune response.”
Case report authors said the doctor’s body likely failed to mount an appropriate response to the tumor cells “transplanted” from the patient’s body (stock image)
While the case was originally reported in 1996, but has resurfaced with renewed interest.
Published in The New England Journal of Medicine, doctors describe the “accidental transplant” of the patient’s malignant fibrous histiocytoma – a rare form of cancer that forms in soft tissue with only 1,400 diagnoses per year.
The doctor injured the palm of his left hand while trying to place a drain in his patient during surgery to remove the cancer from the patient’s abdomen.
The wound was immediately disinfected and bandaged.
Although the cancer patient’s first surgery was successful, he died after complications following the procedure.
Five months later, a hard, 1.5-inch “tumor-like swelling” appeared at the base of the doctor’s left middle finger and he visited a hand specialist.
An ‘extensive’ investigation was carried out, including numerous laboratory and blood tests, which revealed no abnormal findings.
The tumor was removed anyway and examination of the mass under a microscope revealed that it was also a malignant fibrous histiocytoma.
The doctor who had treated both the cancer patient and the surgeon “posed the question of whether the tumors were related.
Samples from both tumors were further analyzed and determined to be ‘identical’.
They both had the same type of cells and the same arrangement of those cells, meaning the surgeon may have unknowingly transferred the patient’s cancer cells to the cut on his hand, allowing the disease to take root and grow in his body.
The authors wrote: ‘Normally, the transplantation of allogeneic tissue from one person to another triggers an immune response that leads to the rejection of the transplanted tissue.
‘In the surgeon’s case, an intense inflammatory response developed in the tissue surrounding the tumor, but the tumor mass increased, indicating an ineffective anti-tumor immune response.’
The authors speculate that the tumor “escaped immunological destruction by several mechanisms,” including changes in the molecules within the cells and the inability of the surgeon’s body to effectively recognize and attack tumor cells.
Two years after the surgeon removed his own tumor, there were no signs that the cancer had spread or returned.
In a recent study, researchers detailed cases of heart transplant recipients who adopted the preferences and memories of their donors
Above are findings from the analysis of the patient’s tumor (left) and the surgeon’s tumor (right). They revealed that the two men had ‘identical’ tumors
Doctors noted that the case was interesting because transplanted tissue is different from the host’s tissue and is usually targeted by the host’s immune system in an attempt to destroy it.
This is why organ recipients must take immunosuppressants to ensure that their body does not reject the transplanted organ.
But even though the surgeon developed inflammation around his original cut, his immune response could not stop the tumor from growing.
Cases like the surgeon’s are extremely rare and there are no statistics on ‘transplanted’ cancer.
A 2013 judgement of these cases, published in the Cold Spring Harbor Perspectives in Medicine, states that there is no estimate of the risk of transmitting cancer from donor to recipient and limited data are available on this topic.
The report’s authors wrote: ‘The incidence of cancer transmission is so low that sporadic case reports are the main source of information.’
One earlier judgement a 1993 study, which looked at data from the 1970s, also found that there were only ‘sporadic’ reports of cancer transmitted through organ donation.
The 2013 review added: ‘The low frequency and highly variable stage of cancer means that definitive risk calculations are impossible.’
However, the authors went on to say that the data “very likely underestimates the true incidence.”
Using the limited data available, the authors of the 2013 report found that cancers known to have been transmitted from donor to recipient on at least one occasion included breast cancer, colon cancer, liver cancer, lung cancer, melanoma, ovarian cancer, prostate cancer and kidney cancer are. cancer.