title: Repeated anastomotic recurrence of colorectal tumors: genetic analysis of two cases.
abstract: OBJECTIVE
  To investigate genetics of two cases of colorectal tumor local recurrence and throw some light on the etiopathogenesis of anastomotic recurrence.
  
  
  METHODS
  Two cases are presented: a 65-year-old female receiving two colonic resections for primary anastomotic recurrences within 21 mo, and a 57-year-old female undergoing two local excisions of recurrent anastomotic adenomas within 26 mo. A loss of heterozygosity (LOH) study of 25 microsatellite markers and a mutational analysis of genes BRAF, K-RAS and APC were performed in samples of neoplastic and normal colonic mucosa collected over the years.
  
  
  RESULTS
  A diffuse genetic instability was present in all samples, including neoplastic and normal colonic mucosa. Two different patterns of genetic alterations (LOH at 5q21 and 18p11.23 in the first case, and LOH at 1p34 and 3p14 in the second) were found to be associated with carcinogenesis over the years. A role for the genes MYC-L (mapping at 1p34) and FIHT (mapping at 3p14.2) is suggested, whereas a role for APC (mapping at 5q21) is not shown.
  
  
  CONCLUSIONS
  The study challenges the most credited intraluminal implantation and metachronous carcinogenesis theories, and suggests a persistent, patient-specific alteration as the trigger of colorectal cancer anastomotic recurrence.
authors: Dipartimento di Scienze Chirurgiche, Università degli Studi di Parma, 43100 Parma, Italy. renatocosti@hotmail.com
authors: Renato
authors: R
authors: Costi
authors: Cinzia
authors: C
authors: Azzoni
authors: Federico
authors: F
authors: Marchesi
authors: Lorena
authors: L
authors: Bottarelli
authors: Vincenzo
authors: V
authors: Violi
authors: Cesare
authors: C
authors: Bordi
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005820:Genetic Testing; D006801:Humans; D019656:Loss of Heterozygosity; D018895:Microsatellite Repeats; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology* / Q000601:surgery