Metastasis to Spleen in a Lynch Syndrome Patient: A Case Report

Aminimoghaddam, Soheila; Vahedpoor, Zahra; Bozorgzadeh, Shabnam

Document Type : Case Report Article

Authors

¹ Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

² Department of Obstetrics and Gynecology, School of Medicine Kashan University of Medical Sciences, Kashan, Iran

Abstract

Hereditary non polyposis colorectal cancer (HNPCC) also known as Lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers, it predisposes patients to extracolonic cancers. Despite several extracolonic cancers have been reported on LS, we found a new face of it. A 43-year-old G2L2 patient with chief complaint of abnormal uterine bleeding. Her endometrium biopsy showed clear cell carcinoma, and the necessary work-ups have been done. But the patient's family history demonstrated HNPCC based on the Amsterdam 2 criteria. After some years, the patient presented to our hospital for fever, shivering and abdominal LUQ pain. Spiral CT scan showed a solid cyst with heterogeneous enhancement in the spleen, and hepatosplenomegaly. In this paper, another case with endometrial cancer as a sentinel cancer of LS is reported. This fact implicate that physicians should notice the family history of malignancies in patients with gynecologic cancers and consider LS.

Highlights

✅ In this paper, another case with endometrial cancer as a sentinel cancer of LS is reported. This fact implicate that physicians should notice the family history of malignancies in patients with gynecologic cancers and consider LS.

Keywords

Main Subjects

Gynecology Oncology

References

1. Barrow E, Hill J, Evans DG. Cancer risk in Lynch syndrome. Fam Cancer. 2013;12(2):229-40. [DOI:10.1007/s10689-013-9615-1] [PMID]

2. Lynch HT, Lynch P, Lanspa S, Snyder C, Lynch J, Boland C. Review of the Lynch syndrome: history, molecular genetics, screening, differential diagnosis, and medicolegal ramifications. Clin Genet. 2009;76(1):1-18. [DOI:10.1111/j.1399-0004.2009.01230.x] [PMID] [PMCID]

3. Lynch HT, de la Chapelle A. Hereditary colorectal cancer. The New England journal of medicine. 2003;348(10):919-32. [DOI:10.1056/NEJMra012242] [PMID]

4. Siraj AK, Prabhakaran S, Bavi P, Bu R, Beg S, Hazmi MA, et al. Prevalence of Lynch syndrome in a Middle Eastern population with colorectal cancer. Cancer. 2015;121(11):1762-71. [DOI:10.1002/cncr.29288] [PMID]

5. King M-C, Marks JH, Mandell JB. Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2. Science. 2003;302(5645):643-6. [DOI:10.1126/science.1088759] [PMID]

6. Umar A, Boland CR, Terdiman JP, Syngal S, Chapelle Adl, Rüschoff J, et al. Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst. 2004;96(4):261-8. [DOI:10.1093/jnci/djh034] [PMID] [PMCID]

7. Palomaki GE, McClain MR, Melillo S, Hampel HL, Thibodeau SN. EGAPP supplementary evidence review: DNA testing strategies aimed at reducing morbidity and mortality from Lynch syndrome. Genet Med. 2009;11(1):42. [DOI:10.1097/GIM.0b013e31818fa2db] [PMID] [PMCID]

8. Lu KH, Dinh M, Kohlmann W, Watson P, Green J, Syngal S, et al. Gynecologic cancer as a "sentinel cancer" for women with hereditary nonpolyposis colorectal cancer syndrome. Obstet Gynecol. 2005;105(3):569-74. [DOI:10.1097/01.AOG.0000154885.44002.ae] [PMID]

9. Soliman PT, Broaddus RR, Schmeler KM, Daniels MS, Gonzalez D, Slomovitz BM, et al. Women with synchronous primary cancers of the endometrium and ovary: do they have Lynch syndrome? J Clin Oncol. 2005;23(36):9344-50. [DOI:10.1200/JCO.2005.03.5915] [PMID]

10. Bengtsson D, Joost P, Aravidis C, Askmalm Stenmark M, Backman AS, Melin B, et al. Corticotroph Pituitary Carcinoma in a Patient With Lynch Syndrome (LS) and Pituitary Tumors in a Nationwide LS Cohort. The Journal of clinical endocrinology and metabolism. 2017;102(11):3928-32. [DOI:10.1210/jc.2017-01401] [PMID]

11. Lu Y, Milchgrub S, Khatri G, Gopal P. Metachronous Uterine Endometrioid Adenocarcinoma and Peritoneal Mesothelioma in Lynch Syndrome: A Case Report. International journal of surgical pathology. 2017;25(3):253-7. [DOI:10.1177/1066896916680745] [PMID]

12. Pelizzo MR, Pennelli G, Zane M, Galuppini F, Colletti PM, Merante Boschin I, et al. Papillary thyroid carcinoma (PTC) in Lynch syndrome: Report of two cases and discussion on Lynch syndrome behaviour and genetics. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2015;74:9-16. [DOI:10.1016/j.biopha.2015.06.008] [PMID]

13. Pugalenthi A, Bradley C, Gonen M, Do KG, Strong V, Jarnagin W, et al. Splenectomy to treat splenic lesions: an analysis of 148 cases at a cancer center. Journal of surgical oncology. 2013;108(8):521-5. [DOI:10.1002/jso.23433] [PMID]

14. Comperat E, Bardier-Dupas A, Camparo P, Capron F, Charlotte F. Splenic metastases: clinicopathologic presentation, differential diagnosis, and pathogenesis. Archives of pathology & laboratory medicine. 2007;131(6):965-9. [DOI:10.5858/2007-131-965-SMCPDD] [PMID]

Journal of Obstetrics, Gynecology and Cancer Research

Metastasis to Spleen in a Lynch Syndrome Patient: A Case Report

References

References

Volume 8, Issue 4 - Serial Number 33
July and August 2023
Pages 421-425

Metastasis to Spleen in a Lynch Syndrome Patient: A Case Report

References

References

Volume 8, Issue 4 - Serial Number 33July and August 2023Pages 421-425

Volume 8, Issue 4 - Serial Number 33
July and August 2023
Pages 421-425