Background: As newer immunosuppressive regimens have steadily reduced in the incidence of acute rejection and have extended the life expectancy of allograft recipients, posttransplant de novo malignancies have become an important cause of death in cadaveric donor transplantation. Also, according with the recent accumulation of living donor liver transplantation (LDLT), the number of posttransplant recipients with de novo malignancy will be anticipated to increase.
Case Report: A 60 year-old man underwent LDLT for hepatitis C virus-related cirrhosis with hepatocellular carcinoma. Thirty months after LDLT, he was found to have gastric cancer by upper gastrointestinal endoscopy. He underwent segmental gastrectomy with lymph node dissection. Histopathological examination of the explanted stomach revealed poorly differentiated adenocarcinoma with subserosal invasion in the gastric wall and perigastric lymph node metastasis. Three years and eight months after the gastric surgery, the patient is alive with no recurrence of gastric cancer or HCC under no adjuvant chemotherapy.
Conclusions: Considering that early detection is the only key in curing cancer in general, we should make effort to detect cancer in their early stage, especially in case of LDLT recipients.

Keywords: LDLT, gastric cancer, de novo malignancy