Colorectal cancer in a patient with intestinal schistosomiasis: a case report from Kilimanjaro Christian Medical Center Northern Zone Tanzania

Abstract

BackgroundColorectal cancer associated with chronic intestinal schistosomiasis has been linked with the chronic inflammation as a result of schistosomal ova deposition in the submucosal layer of the intestine. Among all species Schistosoma japonicum has been more linked to development of colorectal cancer as compared to Schistosoma mansoni due to absence of population-based studies to support the association. Despite the weak evidence, some cases have been reported associating S. mansoni with development of colorectal cancer.Case PresentationWe report a patient who presented to us as a case of intestinal obstruction and found to have a constrictive lesion at the sigmoid colon at laparotomy, then later found to have colorectal cancer with deposited S. mansoni ova at histology.ConclusionGiven the known late complications of schistosomiasis, and as S. mansoni is endemic in some parts of Tanzania, epidemiological studies are recommended to shed more light on its association with colorectal cancer.

Large bowel obstruction secondary to schistosomiasis-related colonic stricture

“…In non-endemic regions with individuals immigrating from affected countries, some guidelines suggested screening for schistosomiasis as a way of improving identification of infected patients, increase treatment rates, and ultimately reduce any complications of disease progression [ 7 , 8 ]. Previous studies have found high rates of active schistosomiasis in immigrants from Schistosoma endemic regions, therefore screening this population with serology and ELISA testing may be effective [ 7 ].…”

“… Diverting transverse colostomy was deemed the safest treatment by consensus. Herman et al (2017) [ 8 ] 52; M Tanzania 4d history of abdo. pain, distension, and constipation.…”

Comparison of the clinicopathological features and prognoses of patients with schistosomal and nonschistosomal colorectal cancer

“…The association between schistosomiasis and CRC has been determined previously (9) and large epidemiological studies have demonstrated an association between CRC and schistosomiasis (10,11). Several studies have suggested that long-term inflammation caused by chronic schistosomal infection is a key factor in the carcinogenic process of CRC (12,13). However, there are only a few studies which have reported differences in the characteristics between patients with schistosomal and nonschistosomal CRC and the number of reported schistosomal CRC cases is low (14,15).…”

Prevalence of schistosomiasis and associated risk factors among school children in Um-Asher Area, Khartoum, Sudan

“…In addition, poor sanitation, bathing and swimming in dams and rivers or crossing rivers on the way to school barefooted, type and consistent use of toilet, uses of unprotected water sources to watering the vegetable gardens and knowledge about schistosomiasis are the risks that significantly associated with higher rates of infection [ 16 ]. The adverse effects of schistosomiasis among this group are diverse and alarming, the infection can lead to urethral and bladder fibrosis and hydronephrosis, hepatosplenomegaly, moreover, bladder cancer and colorectal cancer is a possible late-stage complication [ 17 , 18 ]. Thus, this study was conducted to determine the prevalence of schistosomiasis and the associated risk factors among school age children from Um-Asher area, South Khartoum, Sudan.…”