Chronic Myeloid Leukemia in Patient with Local Recurrence Colon Cancer: A Case Report

Abstract

Chronic Myeloid Leukemia (CML) is a chronic disease that about 50% of patients are more than 60 years old and about 50% of patients are asymptomatic. In this study, It is reported that, a case of CML after colon cancer chemotherapy in a 52 year old male from Iran who diagnosed locally advanced poorly differentiation colon adenocarcinoma with extension to prostate for him that had undergone to chemotherapy induction, then chemoradiation with surgery for mid-rectal cancer in the follow-up with picture of local recurrence and rectovesical-fistula. His first regimen in induction chemotherapy phase been oxaliplatin plus capecitabine and follow with chemoradiation for one month. The KRAS was mutation for the patient. He treated with combination of capecitabine with bevacizumab. After new progression he treated with Xeloda+irinotecan regimen. In routine follow-up in complete blood count analysis, It was found that shift to left with immature granulocytopoietic forms. Analysis by RT-PCR peripheral blood showed that Philadelphia chromosome was positive, so CML was diagnosed for him and was add imatinib to his treatment policy. Combination of oxaliplatin and irinotecan can be carcinogenic even they can probably create secondary hematological malignancy like CML and also irradiation can be other risk factor in patients with colorectal cancer following chemotherapy.

Colorectal cancer metastasis to the thyroid: A case report and review of the literature

“…The background is often mass inflammation, fibrosis, and even mucus; in addition, some normal follicular epithelial cells can be seen, which can form small follicular structures with small nuclei and inconspicuous nucleoli ( 28 , 29 ). Moreover, it is very difficult to differentiate metastatic colorectal cancer from primary undifferentiated (anaplastic) thyroid cancer as several cytological features overlap, including obvious nuclear atypia, coarse chromatin, obvious nucleoli, and a large number of mitotic figures ( 30 ). However, mucinous background and tall columnar cell clusters are not common in primary undifferentiated thyroid cancer; it is also very similar to the tall cell variant and columnar cell variant of thyroid papillary carcinoma ( 31 , 32 ).…”

Solitary thyroid gland metastasis from rectal cancer: A case report and review of the literature

“…Hematogenous spread might be the most important pathway for CRC metastasis to the thyroid[ 19 ]. Indeed, in many cases, thyroid metastasis is accompanied by lung and liver metastases[ 8 , 9 , 12 , 14 - 21 , 23 - 25 ]. Furthermore, among 25 cases reported previously and the present case, 72.0% of all patients (18/25) showed concomitant lung metastasis.…”

“…Furthermore, among 25 cases reported previously and the present case, 72.0% of all patients (18/25) showed concomitant lung metastasis. Therefore, CRC may metastasize to the thyroid via the portal vein, vena cava, and pulmonary vein[ 5 , 15 , 16 , 18 , 20 , 23 ]. The case reported here and cases reported by De Ridder et al [ 13 ] and Onorati et al [ 22 ] had isolated thyroid metastasis with no other organ metastases, which suggests that a circulatory pathway to the thyroid gland bypassing the portal vein, pulmonary vein, and vena cava, through the vertebral venous system, is present[ 30 ].…”