A Case of the Carcinoma of the Small Intesting after Operation for Hereditary Non-polyposis Colorectal Cancer

Yuichi Nakasato, Yoshinori Inagaki, Tomotarou Shinoda, Keiji Onda, Ken Ashikaga, Junko Fujisaki*, Masahiro Ikegami**, Teruaki Aoki

Department of Surgery Jikei University School of Medicine
*Department of Endoscopy, Jikei University School of Medicine
**Department of Pathology, Jikei University School of Medicine

A case of carcinoma of the small intestine after right hemicolectomy for hereditary non-polyposis colorectal cancer (HNPCC) is reported. A 53-year-old man had had 2 colon and 1 rectal cancer lesions, including synchronous and metachronous cancers, since he was 45 years old. His grandfather on the mother's side and his mother had rectal cancer. His 3rd brother had jejunal and colon cancer and his 5 th brother had hepatocellar cancer. He visited our hospital with occult blood in the feces and anemia. An elevated lesion was detected in the jejunum about 5 cm distal to the ligament of Treitz by small bowel radiography and endoscopy. Endoscopic biopsy allowed a histological diagnosis of well-differentiated adenocarcinoma of the jejunum. After admission, partial resection of the jejunum and intraoperative endoscopy of the whole small intestine were performed. Histological examination showed well-differentiated adenocarcinoma of the small intestine. The patient's clinical course was satisfactory and he was discharged on the 17th postoperative day. The HNPCC syndrome includes hereditary site-specific colon cancer (Lynch I) and the cancer family syndrome (Lynch II). This case was classified as Lynch II. Lynch II usually includes carcinomas of the stomach, uterus, and ureter. However, carcinoma of the small intestine had not been reported until our investigation.

Key words
hereditary nonpolyposis colorectal cancer, primary carcinoma of the small intestine, Lynch syndrome II

Reprint requests
Yuichi Nokasato Department of Surgery, Jikei University School of Medicine
3-25-8 Nishishibashi, Minato-ku, Tokyo, 105-0003 JAPAN

Accepted
February 12, 1998

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