Cronkhite-Canada Syndrome Encountered During the Course of Rectal Cancer, Report of a Case Nobuyuki Mizumachi 1,2 , Toshio Taki 1,2 , Yasuhiko Kawasaki 1,2 , Junichi Miyazaki 3 , Ichiro Sekine 4 1Department of Surgery, Kochi Prefectural Seinan Hospital 3Department of Pathology, Kochi Prefectural Seinan Hospital 4Department of Pathology, Atomic Disease Institute Nagasaki University, School of Medicine pp.1033-1040
Published Date 1985/9/25
DOI https://doi.org/10.11477/mf.1403109808
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 A 75-year-old man was diagnosed as having rectal cancer because of bloody stool developed 17 months before hospitalization but he took no account of any treatment. Diarrhea developed 10 months later on and skin pigmentation was subsequently noticed. He had lost about 10 kg in weight in the preceding 14 months and was then hospitalized in August 1981. At the time of hospitalization, atrophied finger-and toe-nails were noted and a localized ulcerating tumor was palpated in the rectum. After hospitalization, loss of hair developed. Laboratory investigation revealed mild anemia, hypocalcemia, hypopotassemia and hypoproteinemia (TP 4.3g/dl). CEA showed a higher value of 12.4ng/ml. Roentgenographic and endoscopic examinations showed numerous polyps in the stomach, colon and rectum, but no polyps were demonstrated in the esophagus and small intestine. Localized ulcerating tumor showing an extended stenosis was observed in the rectum. Biopsy revealed these gastric polyps as hyperplastic and the rectal tumor of adenocarcinoma. Rectectomy was performed for treating rectal cancer. Surgical specimen showed a localized ulcerating tumor sized 6.0×4.7 cm and transverse plica with numerous small polyps. Histologically, the rectal cancer was of well differentiated adenocarcinoma. There were two types of polyp, a major type having cystic dilation of the gland, stromal edema and inflammatory cell infiltration and another minor type showing adenoma or aggregate of adenomatous glands.

 After the operation, diarrhea, alopecia, hyperpigmentation and nail atrophy gradually improved. Polyps on the mucous membrane of artificial anus became lower; redness became less severe and oozing disappeared. However, pneumonia occurred thereafter, followed by recurrence of diarrhea and mucous bloody stool. He ultimately died of pneumonia, one year and eight months after the onset of bloody stool. No definite conclusion is still available concerning the malignant change of polyps in Cronkhite-Canada syndrome.

 Twelve cases of this syndrome associated with cancer are discussed. Consequently, it could suggest that this type of cancer did not result from the malignant change of polyps of Cronkhite-Canada syndrome but this syndrome accidentally occurred in patients with cancer.

Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.


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