Cronkhite-Canada Syndrome Associated with Metastatic Colon Cancer

Abstract

Cronkhite-Canada syndrome is characterized by gastrointestinal and ectodermal manifestations. In this paper, we describe a 64-year-old Iranian male, presenting with Cronkhite-Canada syndrome with metastatic colon cancer. The patient was suffering from hair loss, which occurred on the scalp at first and then, during 5 months, extended to the whole body. After that, his sense of taste was impaired, and 2 months later, gastrointestinal symptoms gradually started, with weight loss of 20 kg over 2 months with an initial weight of 100 kg. Finally, he was admitted to our center 10 months after the onset of symptoms. On skin examination, generalized hair loss and hyperpigmentation and dysmorphic nail changes were observed. Multiple polyps within the colon and sigmoid were observed on colonoscopy. According to biopsies, a serrated adenoma and an invasive adenocarcinoma were reported in the ascending colon and sigmoid, respectively. Other polyps were pseudopolyps, and their characteristics were not significant. Computed tomography of the lungs and abdomen showed multiple adenopathies. On biopsy, metastatic adenocarcinoma was reported. The patient underwent chemotherapy with FOLFIRI and ERBITUX. Finally, after 5 courses of chemotherapy, his regimen was changed to FOLFOX and Avastin because of evidence of progression on computed tomography. The etiology of Cronkhite-Canada syndrome is currently unknown, and the optimal therapy has not been reported so far. This syndrome has many complications; the major of them is malignancy, and the prognosis is poor with a mortality rate of 50%. Therefore, annual monitoring is necessary in these patients.

Comprehensive treatment of Cronkhite-Canada syndrome: A case report and literature review

“…[2] There is no typical pathological type of CCS, and 4 histological types of polyps have been found in patients with CCS: hyperplastic, adenomatous, juvenile and inflammatory. [23] Approximately 12.5% of polyps have been reported to undergo malignant transformation, emphasizing the need to closely monitor these patients. [24] The diagnosis of CCS is based on medical history, physical examination, endoscopic examination of gastrointestinal polyps and histopathology.…”

Cronkhite-Canada syndrome: First case report from Egypt and North Africa

“…Common complications of CCS include anemia, intussusception, rectal prolapse, and GI bleeding, as well as other less common ones such as recurrent severe acute pancreatitis, myelodysplastic syndrome, cecal intussusception, portal thrombosis, membranous glomerulonephritis, and osteoporotic fractures that may result from malabsorption of calcium or prolonged glucocorticoid therapy or both. The most serious complication is malignancy; however, the incidence of CCS-related cancer is estimated to be 5%-25%, especially gastric and colon cancer[ 6 ].…”

Clinical and Endoscopic Characteristics of Chinese Cronkhite-Canada Syndrome Patients: A Retrospective Study of 103 Cases

“…Ya­shiro et al [31] have confirmed genetic changes linking sawtooth adenoma to colorectal cancer and proposed a serrated adenoma-carcinoma sequence in CCS. The data from Haghighi et al [32] have reported that the incidence of cancer in CCS was 15.6% (78/500). It is still controversial whether cancer is a coincidence in CCS patients or developed from benign polyps.…”