Background/Objectives: Despite the long-standing history of liver transplantation (LT) in Spain, no multicenter study has reviewed national outcomes for LT in metastatic neuroendocrine tumors (NETs). In the current era of transplant oncology, auditing these results is essential to refine patient selection and improve long-term outcomes. Methods: This retrospective observational study analyzed data from 13 centers, including 91 patients who underwent LT for NET between 1995 and 2024. Patients were stratified into two groups: Milan IN (those meeting the Milan criteria) and Milan OUT (the remainder). Results: Recurrence occurred in 57.1% of cases, and overall mortality was 51.6%. Of the 91 patients, 71 (78.0%) were Milan IN and 20 (22.0%) were Milan OUT. Five-year overall survival was 71.0% in Milan IN and 58.0% in Milan OUT, with a statistically significant difference. The 5-year disease-free survival (DFS) rate was 58.8% in Milan IN and 36.3% in Milan OUT; this difference was not statistically significant. Conclusions: In conclusion, strict adherence to Milan criteria and incorporation of modern prognostic factors are critical to optimize long-term survival in LT for NET. While the overall outcomes in this historical cohort are modest, future improvements are expected through more rigorous selection and the potential use of bridging or downstaging therapies.

Resumen El estreñimiento crónico es un problema frecuente en ancianos por ello se recurre al uso de laxantes para su resolución. En nuestra imagen presentamos una de las complicaciones poco frecuentes que pueden surgir tras el uso de enemas rectales que presentan fósforo en su composición y su tratamiento. Se inició tratamiento conservador local, presentando mala evolución, por lo que se decidió desbridamiento quirúrgico y colostomía. El postoperatorio evolucionó favorablemente sin presentar complicaciones. Se ha descrito en la literatura la necrosis directa tras la aplicación de enemas en pacientes con deshidratación o insuficiencia renal.