Hereditary Non Polyposis Colon Cancer - A case report

Abstract

A 43 year old male presented with a history of altered bowel habits for 4 months. He was treated elsewhere as a case of amoebiasis. History revealed a strong family history of colorectal malignancies. His father and 3 of his brothers had colonic malignancy. The patient was suspected to have colonic malignancy and evaluated. Hepatic flexure growth was found in CT and confirmed by colonoscopy. A diagnosis of HNPCC was made. The patient was explained of the condition and total procto colectomy was advised. The patient refused radical procedure. Hence segmental resection extended right hemicolectomy was done. Histopathology showed Infiltrating moderately differentiated adenocarcinoma with clear surgical margins. The patient was discharged and started on Chemotherapy. 1 year follow up showed no new lesions. Hereditary nonpolyposis colorectal cancer (HNPCC accounts for about 5-8 of colorectal cancers. Lynch syndrome I is an autosomal dominant inherited disorder characterized by early onset of colorectal cancer, predominance of proximal and multiple tumors, and microsatellite instability. In order to identify HNPCC, the international Amsterdam criteria have been used