Case Report: Multiple colorectal cancers in a patient with Ulcerative colitis and Lynch syndrome: Is there a role for prophylactic colectomy? A short report and review of literature

Abstract

It is a known fact that Lynch syndrome (LS) and Ulcerative colitis (UC) are individually associated with increased risk of colorectal cancer. While there is no conclusive evidence to demonstrate a cumulative risk when these two conditions coexist, available data suggest early onset and synchronous cancers are synonymous to this group. We have reported an unusual case of multiple synchronous colorectal cancers in a young man with ulcerative colitis and Lynch syndrome also known as Hereditary Nonpolyposis Colorectal Cancer (HNPCC) gene mutation. We propose that conducting a detailed genetic mutation profile in LS patients may play a key role in guiding the intensity of endoscopic surveillance and that a concerted, pragmatic, patient guided approach should be adopted on the subject of prophylactic colectomy when UC and LS co-exist.

Alterations in p53, Microsatellite Stability and Lack of MUC5AC Expression as Molecular Features of Colorectal Carcinoma Associated with Inflammatory Bowel Disease

“…The CRC was probably the result of the summatory risk of the two conditions. The presence of IBD and LS in the same patient is a rare situation given the scarce literature reporting these cases [31][32][33][34][35][36][37] and the low rate of germline mutations found in IBD patients [12]. Nevertheless, it is important to exclude LS in those MSI-H CACs to define the outcome in patients with early onset CRC, which is worse in the IBD-related group, intermediate in the sporadic group and best in the hereditary group [35].…”