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.
Subject(s)
Humans , Male , Adenocarcinoma/pathology , Adenocarcinoma/genetics , Adenocarcinoma , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antineoplastic Combined Chemotherapy Protocols , /radiotherapy , /drug therapy , Colitis/pathology , Colitis/etiology , Colorectal Neoplasms/pathology , Colorectal Neoplasms/genetics , Colorectal Neoplasms , Combined Modality Therapy , Cyclophosphamide/adverse effects , Cyclophosphamide , Doxorubicin/adverse effects , Doxorubicin , Genes, p53 , Neoplasm Proteins/analysis , Neoplasms, Radiation-Induced/pathology , Neoplasms, Radiation-Induced/genetics , Neoplasms, Radiation-Induced , Neoplasms, Second Primary , Tumor Suppressor Protein p53/analysis , Radiation Injuries/pathology , Radiation Injuries/etiology , Radiotherapy , /radiotherapy , /drug therapy , Sigmoid Neoplasms/pathology , Sigmoid Neoplasms/genetics , Sigmoid Neoplasms/etiology , Time Factors , Vincristine/adverse effects , VincristineABSTRACT
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.
Subject(s)
Humans , Male , Adenocarcinoma/pathology , Adenocarcinoma/genetics , Adenocarcinoma , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antineoplastic Combined Chemotherapy Protocols , /radiotherapy , /drug therapy , Colitis/pathology , Colitis/etiology , Colorectal Neoplasms/pathology , Colorectal Neoplasms/genetics , Colorectal Neoplasms , Combined Modality Therapy , Cyclophosphamide/adverse effects , Cyclophosphamide , Doxorubicin/adverse effects , Doxorubicin , Genes, p53 , Neoplasm Proteins/analysis , Neoplasms, Radiation-Induced/pathology , Neoplasms, Radiation-Induced/genetics , Neoplasms, Radiation-Induced , Neoplasms, Second Primary , Tumor Suppressor Protein p53/analysis , Radiation Injuries/pathology , Radiation Injuries/etiology , Radiotherapy , /radiotherapy , /drug therapy , Sigmoid Neoplasms/pathology , Sigmoid Neoplasms/genetics , Sigmoid Neoplasms/etiology , Time Factors , Vincristine/adverse effects , VincristineABSTRACT
Se presentan 61 pacientes portadores de Poliposis Adenomatosa Familiar (PAF) a los que se les realizó colectomía total con ileorrectoanastomosis (IRA). Pertenecían al sexo masculino 37 (61 por ciento) y con una mediana de edad de 30 años (mínima 11 y máxima 79 años). La mediana de edad en el momento de la IRA en los 8 pacientes que posteriormente desarrollaron CA del recto fue de 53,5 años (mínimo 17, máximo 79) y de 63 años (mínimo 37-máxima 80) en el momento del diagnóstico de cáncer del recto. Se realizaron 7 protectomías y 1 paciente rechazó la operación. Se estudiaron 4 variables y su relación con el CA del recto remanente: pólipos preoperatorios, pólipos postoperatorios, Ca de colon en el momento de la IRA y la edad. Esta última variable resultó altamente significativa con una P = 0,0019, para los mayores de 50 años. La tasa de progresión a CA del recto fue del 13,1 por ciento y el riesgo actuarial de 6,5 por ciento a los 22 años. El estimado de supervivencia de los pacientes que fallecen por CA del recto es del 65 por ciento a los 33 años, con una mediana de sobrevida de 23 años. La tasa de sobrevida global es 87 por ciento y la mediana 23 años. Conclusiones: El riesgo estimativo de Ca en el muñón rectal remenente es bajo como así también la mortalidad por dicha causa. El tiempo libre de progresión de la enfermedad a Ca del recto dependió de la edad como única variable. La operación de elección es la IRA en pacientes menores de los 50 años, escaso nº de pólipos rectales y posibilidad de un control rectal riguroso
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Adenomatous Polyposis Coli/surgery , Anastomosis, Surgical/methods , Colectomy , Colorectal Surgery , Rectal Neoplasms/mortality , Risk , Adenomatous Polyposis Coli/complications , Adenomatous Polyposis Coli/mortality , Anastomosis, Surgical/statistics & numerical data , Colectomy/statistics & numerical data , Rectal Neoplasms/etiology , Rectal Neoplasms/surgery , Sigmoid Neoplasms/etiology , Survival Analysis , Survival RateABSTRACT
An 18-year-old Filipina presented with a 28 cm retroperitoneal malignant schwannoma arising from the sigmoid colon. Histopathologic examination revealed the presence of numerous schistosome ova immediately adjacent to the tumor and throughout the submucosa. Due to the rarity of malignant schwannomas, their infrequent occurrence in young persons in the absence of von Recklinghausen's neurofibromatosis, and the presence of schistosomal ovideposition, the possible role of schistosomal infection in the development of this malignancy is discussed. This is the first reported case of a malignant schwannoma occurring together with schistosomiasis.