title: Pulmonary sclerosing hemangioma in a 21-year-old male with metastatic hereditary non-polyposis colorectal cancer: report of a case.
abstract: BACKGROUND
  Pulmonary sclerosing hemangioma (SH) is a rare tumor of the lung predominantly affecting Asian women in their fifth decade of life. SH is thought to evolve from primitive respiratory epithelium and mostly shows benign biological behavior; however, cases of lymph node metastases, local recurrence and multiple lesions have been described.
  
  
  METHODS
  We report the case of a 21-year-old Caucasian male with a history of locally advanced and metastatic rectal carcinoma (UICC IV; pT4, pN1, M1(hep)) that was eventually identified as having hereditary non-polyposis colorectal cancer (HNPCC, Lynch syndrome). After neoadjuvant chemotherapy followed by low anterior resection, adjuvant chemotherapy and metachronous partial hepatectomy, he was admitted for treatment of newly diagnosed bilateral pulmonary metastases. Thoracic computed tomography showed a homogenous, sharply marked nodule in the left lower lobe. We decided in favor of atypical resection followed by systematic lymphadenectomy. Histopathological analysis revealed the diagnosis of SH.
  
  
  CONCLUSIONS
  Cases have been published with familial adenomatous polyposis (FAP) and simultaneous SH. FAP, Gardner syndrome and Li-Fraumeni syndrome, however, had been ruled out in the present case. To the best of our knowledge, this is the first report describing SH associated with Lynch syndrome.
authors.affiliation: Department of Surgery, University of Munich, Campus Grosshadern, Germany. Tobias.Schiergens@med.uni-muenchen.de
authors.forename: Tobias S
authors.initials: TS
authors.lastname: Schiergens
authors.forename: Philipe N
authors.initials: PN
authors.lastname: Khalil
authors.forename: Doris
authors.initials: D
authors.lastname: Mayr
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Thasler
authors.forename: Martin K
authors.initials: MK
authors.lastname: Angele
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: Hatz
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Axel
authors.initials: A
authors.lastname: Kleespies
mesh_terms: D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D011013:Pneumonectomy; D047868:Pulmonary Sclerosing Hemangioma / Q000150:complications / Q000601:surgery*; D012004:Rectal Neoplasms / Q000150:complications / Q000628:therapy*; D055815:Young Adult