Cronkhite-Canada syndrome associated with a rectal cancer and adenomatous changes in colonic polyps

Katayama, Yosei; Kimura, Maiko; Konn, Mitsuru

doi:10.1097/00000478-198501000-00011

Cited by 41 publications

(13 citation statements)

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“…Thus, CCS patients have a high risk for development of gastrointestinal cancer. As seen in ours, there were several reports on adenomatous changes in CCS polyps with colorectal cancer [7,8,9]. Murata et al [10] clearly showed a histological transition of adenomatous component to CCS polyps in the colon.…”

Section: Discussionsupporting

confidence: 71%

“…Although CCS was considered a benign condition, cancers occurring in the stomach, colon and rectum of the affected patients have been reported [1,7,8,9]. Yashiro et al [8] reviewed 387 CCS cases, and documented that 50 (13%) cases were associated with gastrointestinal cancer including 31 (8%) of colorectal carcinoma and 19 (5%) of stomach cancer.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Cronkhite-Canada Syndrome: Remission after Treatment with Anti-<i>Helicobacter pylori</i> Regimen

Okamoto¹,

Isomoto²,

Shikuwa³

et al. 2008

Digestion

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A 67-year-old man with nausea, appetite loss, frequent diarrhea and severe weight loss presented with alopecia, skin hyperpigmentation and onychodystrophy. Laboratory investigations showed mild anemia, hypoproteinemia and hypoalbuminemia. Colonoscopy identified the numerous, hyperemic and sessile polyps with mucous exudation of various sizes throughout the colorectum. The ileocecal valve was substantially swollen. Magnified chromoendoscopy revealed sparsely distributed crypt openings with widening of the preicryptal space without destruction in the affected lesions. Upper gastrointestinal endoscopy revealed multiple small, reddish, and sessile polyps in the duodenum and Helicobacter pylori-associated gastritis. Histopathological examination of the colonic polyps revealed cystic dilatation and elongation of scattered glands with epithelial hyperplasia and stromal edema and inflammatory cell infiltrates. Thus, a diagnosis of Cronkhite-Canada syndrome was made. The patient was given clarithromycin, amoxicillin and lansoprazole, resulting in negative ¹³C-urea breath tests. Three months later, his clinical symptoms and edema of the legs resolved with normalization of serum total protein and albumin levels and return to his previous body. The ectodermal abnormalities were resolved 8 months later. On repeat colonoscopic examinations, there was progressive remission of the duodenal and colorectal polyposis, leaving scattered pedunculated polyps in the transverse and ascending colon and on the almost normal-appearing ileocecal valve. At the follow-up magnifying endoscopic examination 8 months later, small round or round-oval pits were densely and regularly distributed.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

A Case of Cronkhite-Canada Syndrome: Remission after Treatment with Anti-<i>Helicobacter pylori</i> Regimen

Okamoto¹,

Isomoto²,

Shikuwa³

et al. 2008

Digestion

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“…This evidence does not always indicate adenomatous transformation of CCS polyps, as reported previously. 4,5 It is possible that a preexisting adenoma was involved in the CCS polyps and that the association was coincidental. However, a significant number of patients with CCS with colorectal adenoma and/or carcinoma have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…However, neoplastic polyps arising within, or in close proximity to, the polyps of CCS have been, rarely, reported. [2][3][4][5] An Canada polyposis, consisting of irregular polypoidal thickening produced by cystically dilated tubules and associated inflammation and edema of the lamina propria. A semi-pedunculated polyp in the descending colon ( Fig.…”

Section: Introductionmentioning

confidence: 99%

Cronkhite-Canada syndrome: report of two cases

Murata

Yoshikawa

Endo

et al. 2000

Journal of Gastroenterology

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Two cases of Cronkhite-Canada syndrome are reported. In the first case, a 56-year-old woman had an adenoma of the colon, arising within the Cronkhite-Canada polyps, which was removed by endoscopic polypectomy. This suggests possible neoplastic transformation of polyps in this syndrome. She achieved remission with corticosteroids, but the polyposis recurred (only in the stomach) 7 months after the remission. In the recurrent polyposis, corticosteroid therapy resulted again in complete remission, which has lasted for 5 years. In the second case, a 69-year-old man developed typical manifestations of the syndrome while under emotional stress. He had a past history of chronic pityriasis lichenoides, and serum antinuclear antibody was positive. These findings suggested a possible role of autoimmune response in the pathogenesis of the syndrome. Corticosteroids were also effective in this patient.

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“…Of the 39 patients, 6 cases including our case underwent an extended radical operation (total or subtotal colectomy). 12,17,20,24 Of these cases, one died from ileus in the early phase postoperatively, two showed an improvement in hypoproteinemia and ectodermal changes, while two other cases including our case showed no remarkable improvement in the symptoms. The other case was not reported in detail.…”

Section: Case Reportmentioning

confidence: 68%

Cronkhite-Canada Syndrome Associated with Advanced Rectal Cancer Treated by a Subtotal Colectomy: Report of a Case

Yamaguchi

Osuga²,

Akagi³

et al. 2001

Surgery Today

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A 41-year-old man with Cronkhite-Canada syndrome presented with multiple juvenile polyps with hyperplastic and adenomatous changes throughout his stomach and entire colorectum. Dysgeusia was recognized and the degree of hypoproteinemia was remarkable. A barium enema study and colonofiberscopy also revealed an advanced cancer in the rectum. Chronic hepatitis B and membranous glomerulonephritis were also present. It was difficult to design a conservative protocol using steroids for the treatment of protein-loosing enteropathy because the patient was a hepatitis B virus carrier. As a result, a subtotal colectomy while preserving the cecum with cecorectal anastomosis was performed. Pathologically, the ulcerated rectal tumor was a moderately differentiated adenocarcinoma with invasion into the muscularis propria. Most polyps showed cystically dilated glands without dysplasia or edematous stroma with inflammatory cell infiltration. A few polyps were juvenile-type polyps with adenoma components. Although no remarkable improvement was observed in the hypoproteinemia postoperatively, an alpha1-antitrypsin clearance test showed a significant decrease in protein loss from the gastrointestinal tract, which was only about one third of the loss seen preoperatively. These findings lead us to conclude that when improvement using conservative treatment can be neither obtained nor is expected, then the use of surgery should be considered when treating patients with Cronkhite-Canada syndrome.

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Cronkhite-Canada syndrome associated with a rectal cancer and adenomatous changes in colonic polyps

Cited by 41 publications

References 0 publications

A Case of Cronkhite-Canada Syndrome: Remission after Treatment with Anti-<i>Helicobacter pylori</i> Regimen

A Case of Cronkhite-Canada Syndrome: Remission after Treatment with Anti-<i>Helicobacter pylori</i> Regimen

Cronkhite-Canada syndrome: report of two cases

Cronkhite-Canada Syndrome Associated with Advanced Rectal Cancer Treated by a Subtotal Colectomy: Report of a Case

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