RESUMEN
Following improvements in therapy for childhood malignancies, the striking increase in survival rate over the past 30 years has led to the increase risk of developing second malignant neoplasms (SMNs). We report a case of colorectal carcinoma as a SMN, following treatment for rhabdomyosarcoma. The patient was diagnosed with rhabdomyosarcoma of the urinary bladder at his age of three years, and developed adenocarcinoma in the colon 13 years later. Histologic examination of the surgical specimen revealed adenocarcinoma involving the rectosigmoid area with radiation colitis in its background. The tumor cells showed strong immunoreactivity for p53 protein, suggesting the role of irradiation and p53 mutation in carcinogenesis. This case emphasizes the need for dose observation in survivors of early childhood malignancies treated with radiation and multiagent chemotherapy.
Asunto(s)
Humanos , Masculino , Adenocarcinoma/patología , Adenocarcinoma/genética , Adenocarcinoma , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica , /radioterapia , /tratamiento farmacológico , Colitis/patología , Colitis/etiología , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/genética , Neoplasias Colorrectales , Terapia Combinada , Ciclofosfamida/efectos adversos , Ciclofosfamida , Doxorrubicina/efectos adversos , Doxorrubicina , Genes p53 , Proteínas de Neoplasias/análisis , Neoplasias Inducidas por Radiación/patología , Neoplasias Inducidas por Radiación/genética , Neoplasias Inducidas por Radiación , Neoplasias Primarias Secundarias , Proteína p53 Supresora de Tumor/análisis , Traumatismos por Radiación/patología , Traumatismos por Radiación/etiología , Radioterapia , /radioterapia , /tratamiento farmacológico , Neoplasias del Colon Sigmoide/patología , Neoplasias del Colon Sigmoide/genética , Neoplasias del Colon Sigmoide/etiología , Factores de Tiempo , Vincristina/efectos adversos , VincristinaRESUMEN
Following improvements in therapy for childhood malignancies, the striking increase in survival rate over the past 30 years has led to the increase risk of developing second malignant neoplasms (SMNs). We report a case of colorectal carcinoma as a SMN, following treatment for rhabdomyosarcoma. The patient was diagnosed with rhabdomyosarcoma of the urinary bladder at his age of three years, and developed adenocarcinoma in the colon 13 years later. Histologic examination of the surgical specimen revealed adenocarcinoma involving the rectosigmoid area with radiation colitis in its background. The tumor cells showed strong immunoreactivity for p53 protein, suggesting the role of irradiation and p53 mutation in carcinogenesis. This case emphasizes the need for dose observation in survivors of early childhood malignancies treated with radiation and multiagent chemotherapy.