HEREDITARY NONPOLYPOSIS COLORECTAL-CANCER ASSOCIATED WITH DUODENAL CARCINOMA - A CASE-REPORT

Citation
K. Konishi et al., HEREDITARY NONPOLYPOSIS COLORECTAL-CANCER ASSOCIATED WITH DUODENAL CARCINOMA - A CASE-REPORT, Japanese Journal of Clinical Oncology, 28(4), 1998, pp. 289-293
Citations number
29
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology
ISSN journal
0368-2811
Volume
28
Issue
4
Year of publication
1998
Pages
289 - 293
Database
ISI
SICI code
0368-2811(1998)28:4<289:HNCAWD>2.0.ZU;2-S
Abstract
Hereditary nonpolyposis colorectal cancer is an autosomal, dominantly inherited disease, characterized by an early age of onset, right colon predominance and an association with various extracolorectal malignan cies. We present a case of a 47-year-old woman who met the clinical cr iteria for the diagnosis of hereditary nonpolyposis colorectal cancer from her past and family histories. She had undergone operations for u terine cancer (histology not confirmed) at age 35 and for advanced can cer of the ascending colon at age 45, Gastroendoscopy revealed a flat elevated lesion, 20 mm in size, with a protrusion (type lla + ls) in t he second portion of the duodenum in March 1996, Additionally, colonos copy showed a flat elevated lesion, 30 mm in size, with an irregular a nd nodular surface (type lla, laterally spreading tumor) in the descen ding colon. After the operation, the resected specimen of the duodenum histologically showed a well-differentiated adenocarcinoma associated with a tubulo-villous adenoma which had invaded the submucosal layer. The tumor of the colon was histologically confirmed to be a moderatel y-differentiated adenocarcinoma with submucosal invasion. A high frequ ency of replication error positivity (4/5 loci) was detected in both o f the tumors. Reports of early cancer of the duodenum, associated with extracolorectal malignancies in hereditary nonpolyposis colorectal ca ncer, are very rare in the literature. Although it is difficult to det ermine which extracolorectal tumor sites should be taken into consider ation by screening prog rams, we believe that careful observation by u pper gastrointestinal endoscopy, which includes the duodenum, is neces sary for patients with hereditary nonpolyposis colorectal cancer.