Interval colon cancer in a Lynch syndrome patient under annual colonoscopic surveillance: a case for advanced imaging techniques?

Amy S. Oxentenko, Thomas Christopher Smyrk

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Lynch syndrome confers increased risk for various malignancies, including colorectal cancer. Colonoscopic surveillance programs have led to reduced incidence of colorectal cancer and reduced mortality from colorectal cancer. Colonoscopy every 1-2 years beginning at age 20-25, or 10 years earlier than the first diagnosis of colorectal cancer in a family, with annual colonoscopy after age 40, is the recommended management for mutation carriers. Screening programs have reduced colon cancer mortality, but interval cancers may occur.Case presentation: We describe a 48-year-old woman with Lynch syndrome who was found to have an adenoma with invasive colorectal cancer within one year after a normal colonoscopy.Conclusion: Our patient illustrates two current concepts about Lynch syndrome: 1) adenomas are the cancer precursor and 2) such adenomas may be " aggressive," in the sense that the adenoma progresses more readily and more rapidly to carcinoma in this setting compared to usual colorectal adenomas. Our patient's resected tumor invaded only into submucosa and all lymph nodes were negative; in that sense, she represents a success for annual colonoscopic surveillance. Still, this case does raise the question of whether advanced imaging techniques are advisable for surveillance colonoscopy in these high-risk patients.

Original languageEnglish (US)
Article number50
JournalBMC Gastroenterology
Volume12
DOIs
StatePublished - May 24 2012

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Hereditary Nonpolyposis Colorectal Neoplasms
Adenoma
Colonic Neoplasms
Colorectal Neoplasms
Colonoscopy
Neoplasms
Mortality
Early Diagnosis
Lymph Nodes
Carcinoma
Mutation
Incidence

Keywords

  • Colorectal carcinoma, Surveillance
  • Lynch syndrome

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Interval colon cancer in a Lynch syndrome patient under annual colonoscopic surveillance : a case for advanced imaging techniques? / Oxentenko, Amy S.; Smyrk, Thomas Christopher.

In: BMC Gastroenterology, Vol. 12, 50, 24.05.2012.

Research output: Contribution to journalArticle

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