J Korean Med Sci.  2000 Aug;15(4):475-477. 10.3346/jkms.2000.15.4.475.

Colorectal adenocarcinoma as a second malignant neoplasm following rhabdomyosarcoma of the urinary bladder: a case report

• Park SS
• Kim BK
• Kim CJ
• Kim WS
• Kim IO
• Park KW
• Shin HY
• Ahn HS

• KMID: 1730650
• DOI: http://doi.org/10.3346/jkms.2000.15.4.475

Abstract

Following improvements in therapy for childhood malignancies, the striking increase in survival rate over the past 30 years has led to the increase risk of developing second malignant neoplasms (SMNs). We report a case of colorectal carcinoma as a SMN, following treatment for rhabdomyosarcoma. The patient was diagnosed with rhabdomyosarcoma of the urinary bladder at his age of three years, and developed adenocarcinoma in the colon 13 years later. Histologic examination of the surgical specimen revealed adenocarcinoma involving the rectosigmoid area with radiation colitis in its background. The tumor cells showed strong immunoreactivity for p53 protein, suggesting the role of irradiation and p53 mutation in carcinogenesis. This case emphasizes the need for dose observation in survivors of early childhood malignancies treated with radiation and multiagent chemotherapy.

Keyword

Neoplasms, Second Primary; Colorectal Meoplasms; Child; Rhabdomyosarcoma

MeSH Terms

Adenocarcinoma/pathology
Adenocarcinoma/genetics
Adenocarcinoma/etiology+ACo-
Adolescence
Antineoplastic Agents, Combined/therapeutic use
Antineoplastic Agents, Combined/adverse effects+ACo-
Bladder Neoplasms+ACo-/radiotherapy
Bladder Neoplasms+ACo-/drug therapy
Case Report
Colitis/pathology
Colitis/etiology
Colorectal Neoplasms/pathology
Colorectal Neoplasms/genetics
Colorectal Neoplasms/etiology+ACo-
Combined Modality Therapy
Cyclophosphamide/adverse effects
Cyclophosphamide/administration +ACY- dosage
Doxorubicin/adverse effects
Doxorubicin/administration +ACY- dosage
Genes, p53
Human
Male
Neoplasm Proteins/analysis
Neoplasms, Radiation-Induced/pathology
Neoplasms, Radiation-Induced/genetics
Neoplasms, Radiation-Induced/etiology+ACo-
Neoplasms, Second Primary/etiology+ACo-
Protein p53/analysis
Radiation Injuries/pathology
Radiation Injuries/etiology
Radiotherapy/adverse effects+ACo-
Rhabdomyosarcoma+ACo-/radiotherapy
Rhabdomyosarcoma+ACo-/drug therapy
Sigmoid Neoplasms/pathology
Sigmoid Neoplasms/genetics
Sigmoid Neoplasms/etiology
Time Factors
Vincristine/adverse effects
Vincristine/administration +ACY- dosage