Colonic Adenocarcinoma With Malakoplakia of Colon - A Case Report

Abstract

ABSTRACT:The gastrointestinal tract is the most common site for malakoplakia outside the urinary tract. A variety of conditions co-exists with malakoplakia including inflammatory bowel disease, systemic lupus erythematosus, immunodeficiency and tuberculosis. Rarely, it is associated with colonic adenocarcinoma or adenomas. We report a case of malakoplakia in association with colonic adenocarcinoma.

Vaginal Malakoplakia

“…32 Andrés et al 33 studied 6 cases of malakoplakia with adenocarcinoma to conclude that the distortion of the local flora caused by the tumor could cause malakoplakia. 34 Malakoplakia is best treated with antibiotic therapy after surgical debridement. Fluoroquinolones and trimethoprim sulfamethoxazole are most commonly used to treat malakoplakia.…”

“…A possible mechanism that alters macrophage response to cause malakoplakia is because of a deficiency in guanosine monophosphate dehydrogenase and β-glucuronidase 32 . Andrés et al 33 studied 6 cases of malakoplakia with adenocarcinoma to conclude that the distortion of the local flora caused by the tumor could cause malakoplakia 34 …”

Malakoplakia in a colonic tubular adenoma: a unique case presentation

“…The mode of the occurrence in relation to age is characterised by bimodal pattern, the first prevalence is below age of 13 and the second group is the middle -aged adults, however the average age at diagnosis is 50 years [12][13][14][15][16][17][18]. It has since been reported at other sites, including the gastrointestinal tract (GIT) [7,8,19], the skin [9], the vagina [10], the central nervous system [20], the lungs [21], pancreas [15] and the gallbladder [22].The second group is the middle-aged adults, however the average age at diagnosis is 50 years [12][13][14]. Clinical presentation varies from incidental finding during a procedure, to a symptomatic mass lesion.…”

“…Malakoplakia was first reported outside of the genitourinary system in 1958 by Haukohl and Chinchinian [23]. Regarding the GIT involvement, it has been regarded as the second most common site (12-15%) [14], and frequently seen in the left hemi-colon, between the descending colon and rectum [19,24].The pathogenesis of malakoplakia is not completely understood, but three possible mechanisms have been suggested [16]. These mechanisms suggest that malakoplakia may be due to specific microorganisms, from which Escherichia coli, Mycobacterium tuberculosis, Proteus, and Staphylococcus aureus are the most likely agents, an abnormal or altered immune response in the patient, or due to defective lysosomal function In immunocompromised patients, chronic infection may result in lowering levels of cyclic guanosine monophosphate nucleotide (cGMP) in the cellular microtubules.…”