Morphée généralisée révélatrice d’un adénocarcinome rectal

Abstract

The term Scleroderma unites a heterogeneous group of disease of conjunctive tissue with, unknown in etiology and wich have together an induration of the skin. The association of the scleroderma and neoplasy were not clearly reported. We report an observation of association between a generalised morphea and a rectal cancer. Ms D.B., aged of 62 years old, with no pathologic antecedents, was hospitalised in 2005 for multiple plaques, white, indurated, and localised in the trunk and the lower extremities. The lesions have evolved for one month and a half. The diagnosis of generalised morphea was suspected. The cutaneous biopsy concluded a scleroderma. The antinuclear antibody (anti-Scl 70) was negative. The patient was treated by prednisone (0,75 mg/kg/day) with a slight amelioration. During his hospitalisation, the patient suffered from constipation and the questionnaire showed a sensation of intrarectal body since 3 months. The rectoscopy revealed a big rectal tumor. The rectal biopsy concluded to differentiated luberkinien adenocarcinoma. This rectal tumor was treated by a radiotherapy associated with chemotherapy then followed by surgery. The morphea worsened 2 months later. The association between the generalised morphea and the cancer is rare. There is many arguments to paraneoplasic character of generalised morphea.