Clin Endosc.  2013 May;46(3):301-305. 10.5946/ce.2013.46.3.301.

Cronkhite-Canada Syndrome Associated with Serrated Adenoma and Malignant Polyp: A Case Report and a Literature Review of 13 Cronkhite-Canada Syndrome Cases in Korea

• Yun SH
• Cho JW
• Kim JW
• Kim JK
• Park MS
• Lee NE
• Lee JU
• Lee YJ

• KMID: 2048939
• DOI: http://doi.org/10.5946/ce.2013.46.3.301

Abstract

Cronkhite-Canada syndrome (CCS) is a rare nonfamilial polyposis syndrome characterized by epithelial disturbances both in the gastrointestinal tract and in the epidermis. The pathologic finding of the polyp is usually a hamartomatous polyp of the juvenile type; however, the possibility of serrated adenoma associated malignant neoplasm was reported in some Japanese cases. Up till now in South Korea, 13 CCS cases have been reported, but there was no case accompanied by the colon cancer. We report the first case of CCS associated with malignant colon polyp and serrated adenoma in Korea. A 72-year-old male patient who complained of diarrhea and weight loss was presented with both hands and feet nail dystrophy, hyperpigmentation, and alopecia. Endoscopic examination showed numerous hamartomatous polyps from the stomach to the colon. The pathologic results confirmed colon cancer and serrated adenoma. Helicobacter pylori eradication and prednisolone was used. Thus, the authors report this case along with a literature review.

Keyword

Intestinal polyposis; Colonic neoplasms; Serrated adenoma; Helicobacter pylori

MeSH Terms

Adenoma
Alopecia
Asian Continental Ancestry Group
Colon
Colonic Neoplasms
Diarrhea
Epidermis
Foot
Gastrointestinal Tract
Hand
Helicobacter pylori
Humans
Hyperpigmentation
Intestinal Polyposis
Korea
Male
Nails
Polyps
Prednisolone
Republic of Korea
Stomach
Weight Loss
Prednisolone

Figure

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  Fig. 1 Patient appearance findings. (A) Hair pull test showed that more than 10 hairs were pricked out. (B) Black pigmentation and (C) nail dystrophy was observed in both hand.

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  Fig. 2 Endoscopic findings. (A) Several hundred 0.5- to 2.5-cm-sized, strawberry-like polyps with normal mucosa in the gastric antrum. (B) Numerous tiny polyps in the small bowel on capsule endoscopy. (C) A 15-mm-sized, grape-shaped polyp (black arrow) with thousands of polyps in the transverse colon (pathologically confirmed adenocarcinoma in situ). (D) A 10-mm-sized, round-shaped polyp (black arrow) in the ascending colon (pathologically confirmed serrated adenoma).

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  Fig. 3 Pathologic findings of colonoscopic polypectomy. (A) Inflamed lamina propria, proliferated tortuous and cystic dilated glands (H&E stain, ×200), (B) adenocarcinoma in situ with background low grade tubular adenomas (H&E stain, ×200), (C) adenocarcinoma in situ (H&E stain, ×400), and (D) serrated adenoma (H&E stain, ×400) were observed.

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