Navigating Malignancies in Liver Transplant Recipients: Challenges in Diagnosis and Management

Liver transplant recipients are at increased risk for malignancy due to long-term immunosuppression, which complicates the evaluation of new lesions. We present a case involving a transplant recipient initially diagnosed with metastatic gastric adenocarcinoma based on imaging that suggested liver involvement. The patient underwent systemic chemotherapy before multidisciplinary review and follow-up imaging reclassified the hepatic lesion as a benign cyst. This allowed for curative surgical resection of the primary tumor. The case highlights the importance of diagnostic precision, vigilance against cognitive biases such as anchoring, and the critical role of multidisciplinary collaboration in managing immunosuppressed patients with new oncologic findings.