Colorectal adenocarcinoma as a second malignant neoplasm following rhabdomyosarcoma of the urinary bladder: a case report.
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.
Park
S S
SS
Department of Pathology, Seoul National University Children's Hospital College of Medicine, Korea. ssp98@hanmail.net
Kim
B K
BK
Kim
C J
CJ
Kim
W S
WS
Kim
I O
IO
Park
K W
KW
Shin
H Y
HY
Ahn
H S
HS
D000230:Adenocarcinoma / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003092:Colitis / Q000209:etiology / Q000473:pathology; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D016158:Genes, p53; D006801:Humans; D008297:Male; D009363:Neoplasm Proteins / Q000032:analysis; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects*; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000532:radiotherapy; D012811:Sigmoid Neoplasms / Q000209:etiology / Q000235:genetics / Q000473:pathology; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D009363:Neoplasm Proteins; D016159:Tumor Suppressor Protein p53; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide