RESUMO
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.
Assuntos
Humanos , Masculino , Adenocarcinoma/patologia , Adenocarcinoma/genética , Adenocarcinoma , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica , /radioterapia , /tratamento farmacológico , Colite/patologia , Colite/etiologia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/genética , Neoplasias Colorretais , Terapia Combinada , Ciclofosfamida/efeitos adversos , Ciclofosfamida , Doxorrubicina/efeitos adversos , Doxorrubicina , Genes p53 , Proteínas de Neoplasias/análise , Neoplasias Induzidas por Radiação/patologia , Neoplasias Induzidas por Radiação/genética , Neoplasias Induzidas por Radiação , Segunda Neoplasia Primária , Proteína Supressora de Tumor p53/análise , Lesões por Radiação/patologia , Lesões por Radiação/etiologia , Radioterapia , /radioterapia , /tratamento farmacológico , Neoplasias do Colo Sigmoide/patologia , Neoplasias do Colo Sigmoide/genética , Neoplasias do Colo Sigmoide/etiologia , Fatores de Tempo , Vincristina/efeitos adversos , VincristinaRESUMO
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.