Cronkhite-Canada syndrome associated with advanced rectal cancer treated by a subtotal colectomy: Report of a case

Citation
K. Yamaguchi et al., Cronkhite-Canada syndrome associated with advanced rectal cancer treated by a subtotal colectomy: Report of a case, SURG TODAY, 31(6), 2001, pp. 521-526
Citations number
35
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
SURGERY TODAY
ISSN journal
0941-1291 → ACNP
Volume
31
Issue
6
Year of publication
2001
Pages
521 - 526
Database
ISI
SICI code
0941-1291(2001)31:6<521:CSAWAR>2.0.ZU;2-5
Abstract
A 41-year-old man with Cronkhite-Canada syndrome presented with multiple ju venile polyps with hyperplastic and adenomatous changes throughout his stom ach and entire colorectum. Dysgeusia was recognized and the degree of hypop roteinemia was remarkable. A barium enema study and colonofiberscopy also r evealed an advanced cancer in the rectum. Chronic hepatitis B and membranou s glomerulonephritis were: also present. It was difficult to design a conse rvative protocol using steroids for the treatment of protein loosing entero pathy because the patient was a hepatitis B virus carrier. As a result, a s ubtotal colectomy while preserving the cecum with cecorectal anastomosis wa s performed. Pathologically, the ulcerated rectal tumor was a moderately di fferentiated adenocarcinoma with invasion into the muscularis propria. Most polyps showed cystically dilated glands without dysplasia or edematous str oma with inflammatory cell infiltration. A, few polyps were juvenile-type p olyps with adenoma components. Although no remarkable improvement was obser ved in the hypoproteinemia postoperatively, an alpha1-antitrypsin clearance test showed a significant decrease in protein loss from the gastrointestin al tract, which was only about one third of the loss seen preoperatively. T hese findings lead us to conclude that when improvement using conservative treatment can be nei ther obtained nor is expected, then the use of surgery should be considered when treating patients with Cronkhite-Canada syndrome .