Iranian Society of Gynecology Oncology


1 Gynecologist oncologistIran university of medical sciencesTehran.Iran

2 Kashan University of Medical Sciences and Health Services

3 Iran University of Medical Sciences, Tehran, Iran


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 extra-colonic cancers. The screening may be effective for early detection of colorectal cancers, whereas the efficacy of surveillance for other organ tumors has not yet been established. Despite several extra-colonic cancer 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 (AUB) referred to a gynecologist. A biopsy of her endometrium 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. Germline mutations in the MSH2 gene and MSH6 gene in genetic testing, was consistent with diagnosis of lynch syndrome. After some years the patient presented to our hospital for fever, shimmering and abdominal LUQ pain. The patient had dyspnea, coughing, and had lost some weight. Spiral CT scan showed a solid cyst with heterogeneous enhancement in spleen, and hepatosplenomegaly.
In this paper, another case with endometrial cancer as a sentinel cancer of lynch syndrome is reported. This fact implicate that physicians should notice the family history of malignancies in patients with gynecologic cancers and consider lynch syndrome. Many case reports have been published, but any of them have not been reported spleen involvement yet.


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