Is colonoscopy sufficient for colorectal cancer surveillance in all HNPCC patients?
A 34-year-old male with hereditary non-polyposis colon cancer with a mutation in hMSH2 line is reported. Despite regular colonoscopic follow-up, he developed cecal cancer involving the extraluminal area. Due to sub-occlusive symptoms, the patient was submitted to further colonoscopy, however with no clear evidence of neoplasia. Thin slice multiplanar reconstruction computed tomography CT scan performed thereafter revealed a transmural mass 2.5 cm in size localized near the cecal valve. Discussion is made on the reliability of colonoscopic examinations as well as the need for further investigations in the follow-up of patients at very high risk of right-sided colon cancer, such as male hMSH2 carrier affected by hereditary non-polyposis colon cancer.
Corleto
Vito D
VD
Department of Digestive and Liver Diseases, II School of Medicine, University La Sapienza, Centro Ricerche S. Pietro FBF, Rome, Italy. corleto@bce.uniroma1.it
Zykaj
Ermira
E
Mercantini
Paolo
P
Pilozzi
Emanuela
E
Rossi
Michele
M
Carnuccio
Antonella
A
Di Giulio
Emilio
E
Ziparo
Vincenzo
V
Delle Fave
Gianfranco
G
D000328:Adult; D003113:Colonoscopy / Q000592:standards*; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D006801:Humans; D008297:Male; D010375:Pedigree; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed