J Korean Soc Coloproctol.  2010 Feb;26(1):80-84. 10.3393/jksc.2010.26.1.80.

Synchronous Multiple Colorectal Cancer Occurring in Polyposis

• Ham YC
• Kim IM
• Yun J
• Park SS
• Shin DG
• Kang SK

• KMID: 1818363
• DOI: http://doi.org/10.3393/jksc.2010.26.1.80

Abstract

The frequencies of multiple synchronous carcinomas of the colon and the rectum have been reported to range from 2.1 to 6.3%. Currently, the frequency is higher in colorectal cancer patients, and the diagnosis is better due to the many diagnostic tools that have been developed. There are a few reported cases of five cancers in a patient at the same time. We report here on the case of five synchronous cancers arising from the colon and the rectum in a patient without a familial history of colon cancer or of genetic predisposing factor. The patient was a 62-yr-old woman who presented with frequently loose stool for six months and intermittent abdominal pain for two months. Colonoscopic examination revealed two adenocarcinomas, one each at the sigmoid colon and the rectum; the cancer in the sigmoid colon was obstructed at nearly 40 cm above the anal verge. Computed tomographic colonoscopy revealed many other polyps and masses in the colon and a metastatic mass at segment 8 in the liver. A total proctocolectomy and ileostomy were performed. Histologic evaluation revealed the five lesions to be adenocarcinomas invading the pericolic fat; 1 out of 30 lymph nodes was invaded by the cancer cells.

Keyword

Synchronous multiple colorectal cancer; Computed tomographic colonoscopy; Adenocarcinoma; Polyposis; Total proctocolectomy

MeSH Terms

Abdominal Pain
Adenocarcinoma
Colon
Colon, Sigmoid
Colonic Neoplasms
Colonoscopy
Colorectal Neoplasms
Female
Humans
Ileostomy
Liver
Lymph Nodes
Polyps
Rectum