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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2006 June;19(3):231-4
Synchronous colon and breast cancer
Vadalà G., Sangani G., Azzolina R., Evola G., Bonanno F., Evola F. R., Vadalà S., Sanfilippo G.
II Cattedra di Chirurgia d’Urgenza e P. S. dell’Università di Catania, Catania (Titolare: Prof. G. Vadalà)
Lynch II syndrome (or hereditary non-polyposis colorectal cancer) is characterized by the onset of colorectal cancer associated with that of other primary malignant, synchronous or metachronous, cancers in sites other than the colon such as: breast cancer, endometrial cancer, ovarian cancer, kidney cancer, stomach cancer and numerous others. Experiments carried out by a number of authors assign a genic pathogenesis to this pathology; it would appear, in fact, that various genes are involved; hMSH2, MLH, hPMS1, and hPMS2 prove to be deleted in more than 50% of patients with HNPCC. Colorectal cancer not associated with polyposis syndrome (or HNPCC) represents about 5% of all colorectal tumors. The survival rate for hereditary tumors of the colon is higher than for sporadic forms.
The case of a lady patient suffering from occlusion stage cancer of the caecum (moderately differentiated mucinous adenocarcinoma) and synchronous infiltrating ductal cancer of the right breast, led us to classify her pathology as Lynch II Syndrome. The patient was immediately subjected to two surgical operations: right hemicolectomy with removal of the tumor, and right superior external quadrantectomy.
The contemporaneous treatment of both cancers had no contraindication. Furthermore, at one-year follow-up, the patient was in a good state of health.
It is clear that the study of this syndrome is of considerable importance for the purposes of its prevention; so in patients in whom DNA mutations typical of this syndrome are observed, it is recommended that frequent colonscopic examinations be carried out as from the age of 25, associated with investigation of the other organs that might be involved.