Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome

We report a case of rectal cancer with microsatellite instability (MSI) that probably resulted from Lynch syndrome and that was diagnosed after Cesarean section. The patient was a 28-year-old woman (gravid 1, para 1) without a significant medical history. At 35 gestational weeks, vaginal ultrasonogr...

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Main Authors: Tomohiro Okuda, Hiroshi Ishii, Sadao Yamashita, Sakura Ijichi, Seiki Matsuo, Hiroyuki Okimura, Jo Kitawaki
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2015/479753
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author Tomohiro Okuda
Hiroshi Ishii
Sadao Yamashita
Sakura Ijichi
Seiki Matsuo
Hiroyuki Okimura
Jo Kitawaki
author_facet Tomohiro Okuda
Hiroshi Ishii
Sadao Yamashita
Sakura Ijichi
Seiki Matsuo
Hiroyuki Okimura
Jo Kitawaki
author_sort Tomohiro Okuda
collection DOAJ
description We report a case of rectal cancer with microsatellite instability (MSI) that probably resulted from Lynch syndrome and that was diagnosed after Cesarean section. The patient was a 28-year-old woman (gravid 1, para 1) without a significant medical history. At 35 gestational weeks, vaginal ultrasonography revealed a 5 cm tumor behind the uterine cervix, which was diagnosed as a uterine myoma. The tumor gradually increased in size and blocked the birth canal, resulting in the patient undergoing an emergency Cesarean section. Postoperatively, the tumor was diagnosed as rectal cancer with MSI. After concurrent chemoradiation therapy, a lower anterior resection was performed. The patient’s family history revealed she met the criteria of the revised Bethesda guidelines for testing the colorectal tumor for MSI. Testing revealed that the tumor did indeed show high MSI and, combined with the family history, suggested this could be a case of Lynch syndrome. Our findings emphasize the importance of considering the possibility of Lynch syndrome in pregnant women with colorectal cancer, particularly those with a family history of this condition. We suggest that the presence of Lynch syndrome should also be considered for any young woman with endometrial, ovarian, or colorectal cancer.
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institution OA Journals
issn 2090-6684
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publishDate 2015-01-01
publisher Wiley
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series Case Reports in Obstetrics and Gynecology
spelling doaj-art-aadbbf1961ea41278f4566cd68899d292025-08-20T02:20:54ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922015-01-01201510.1155/2015/479753479753Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch SyndromeTomohiro Okuda0Hiroshi Ishii1Sadao Yamashita2Sakura Ijichi3Seiki Matsuo4Hiroyuki Okimura5Jo Kitawaki6Department of Obstetrics and Gynecology, Fukuchiyama City Hospital, 231 Atsunaka-cho, Fukuchiyama, Kyoto 620-8505, JapanISHII Medical Clinic, Kyoto 617-0002, JapanDepartment of Obstetrics and Gynecology, Fukuchiyama City Hospital, 231 Atsunaka-cho, Fukuchiyama, Kyoto 620-8505, JapanDepartment of Obstetrics and Gynecology, Fukuchiyama City Hospital, 231 Atsunaka-cho, Fukuchiyama, Kyoto 620-8505, JapanDepartment of Obstetrics and Gynecology, Fukuchiyama City Hospital, 231 Atsunaka-cho, Fukuchiyama, Kyoto 620-8505, JapanDepartment of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanWe report a case of rectal cancer with microsatellite instability (MSI) that probably resulted from Lynch syndrome and that was diagnosed after Cesarean section. The patient was a 28-year-old woman (gravid 1, para 1) without a significant medical history. At 35 gestational weeks, vaginal ultrasonography revealed a 5 cm tumor behind the uterine cervix, which was diagnosed as a uterine myoma. The tumor gradually increased in size and blocked the birth canal, resulting in the patient undergoing an emergency Cesarean section. Postoperatively, the tumor was diagnosed as rectal cancer with MSI. After concurrent chemoradiation therapy, a lower anterior resection was performed. The patient’s family history revealed she met the criteria of the revised Bethesda guidelines for testing the colorectal tumor for MSI. Testing revealed that the tumor did indeed show high MSI and, combined with the family history, suggested this could be a case of Lynch syndrome. Our findings emphasize the importance of considering the possibility of Lynch syndrome in pregnant women with colorectal cancer, particularly those with a family history of this condition. We suggest that the presence of Lynch syndrome should also be considered for any young woman with endometrial, ovarian, or colorectal cancer.http://dx.doi.org/10.1155/2015/479753
spellingShingle Tomohiro Okuda
Hiroshi Ishii
Sadao Yamashita
Sakura Ijichi
Seiki Matsuo
Hiroyuki Okimura
Jo Kitawaki
Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome
Case Reports in Obstetrics and Gynecology
title Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome
title_full Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome
title_fullStr Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome
title_full_unstemmed Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome
title_short Rectal Cancer Diagnosed after Cesarean Section in Which High Microsatellite Instability Indicated the Presence of Lynch Syndrome
title_sort rectal cancer diagnosed after cesarean section in which high microsatellite instability indicated the presence of lynch syndrome
url http://dx.doi.org/10.1155/2015/479753
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