Case Of Cronkhite-Canada Syndrome Research Articles

Cronkhite-Canada syndrome tends to be accompanied by colorectal cancer: Report of seven cases.

Cronkhite-Canada syndrome (CCS) can be difficult to diagnose. To diagnose CCS, it is important to perform endoscopic examination for patients with chronic diarrhea, check for the presence or absence of polyposis, and evaluate inflammation in the mucosa between the polyps. This study reported seven cases of CCS. The age of the patients, which included four men and three women, ranged 48-72 years, and all patients were Asian. The most common symptom among these patients was chronic diarrhea. Three of the patients had rectal cancer. In two patients, the lesions were detected at an early stage and resected via endoscopic treatment. CCS is associated with a high risk of malignant gastrointestinal lesions, especially rectal cancers, and periodic surveillance endoscopy and careful observation are required.

A Case of Cronkhite-Canada Syndrome with Alopecia as a Diagnostic Clue

A Case of Cronkhite-Canada Syndrome with Alopecia as a Diagnostic Clue

A case of Cronkhite-Canada syndrome complicating colon cancer and confirming endoscopic course

A case of Cronkhite-Canada syndrome complicating colon cancer and confirming endoscopic course

P095 The Very Interesting Small Bowel Lesions of Cronkhite-Canada Syndrome

BACKGROUND: Cronkhite-Canada syndrome (CCS) is a non-hereditary disease characterized by the presence of gastrointestinal polyposis and skin symptoms such as hair loss, nail plate atrophy, and skin pigmentation. Approximately 50% of cases of CCS also have small bowel lesions. However, there have been few image reports of the small intestine lesions. METHODS: We examined the findings of small intestine capsule endoscopy (CE) in 3 cases of CCS in our hospital. RESULTS: Case 1 was of a 64-year-old male whose chief complaint was diarrhea, abnormal taste, and weight loss. He had diarrhea for 2 months and aware of finger pigmentation and nail atrophy. Esophagogastroduodenoscopy (EGD) revealed a collection of reddish polyps that expanded in the stomach and duodenum, and colonoscopy (CS) revealed glossy reddish bumps in the colon. CE showed diffuse reddish, edematous mucosa and villi enlargement in the entire small bowel. From these characteristic endoscopic and skin findings, he was diagnosed with CCS and was started on prednisolone (PSL) treatment. The treatment response was good, and there was no relapse. Case 2 was of a 65-year old female whose chief complaint was skin pigmentation. She had been aware of pigmentation on her back, palms, and upper arms, and loss of fingernails for the last 6 years with repeated disappearances and exacerbations. Furthermore, erosive gastritis and gastric hyperplastic polyps had been detected 4 years ago, and she was followed-up for these symptoms. Gradually, she became aware of nausea and loose stools, which prompted her to visit our hospital. EGD and CS revealed multiple reddish polyps predominantly in the gastric antrum, villous atrophy and reddish polyps in the terminal ileum, and scattered reddish polyps in the entire colon. Mucosal biopsies revealed glandular dilation, mucosal edema, and inflammatory cell infiltration. CE showed diffuse mulberry ridges and villi atrophy throughout the small bowel. She was diagnosed with CCS based on characteristic clinical and endoscopic findings, and was started on steroid treatment. There was no relapse. Case 3 was of a 75-year old male whose chief complaint was diarrhea and hair loss. EGD and CS revealed multiple polyps in the stomach, duodenum, and colon. CE showed reddish edematous mucosa and villi mixed with atrophy and swelling in the small bowel. Of note were that these findings were found in the jejunum. He was diagnosed with CCS and started on PSL and immunomodulator. Four years later, the characteristic findings disappeared in the CE. CONCLUSION(S): All patients had lesions in the entire small bowel, but there they were not associated with clinical findings or steroid response. The mucosa of the small intestine were more likely to have various findings as the period from onset to diagnosis became longer.

Clinical diagnosis and treatment of 13 cases of Cronkhite-Canada syndrome

Clinical diagnosis and treatment of 13 cases of Cronkhite-Canada syndrome

Cronkhite-Canada syndrome: A case report.

Cronkhite-Canada syndrome (CCS) is a rare non-inherited condition characterized by gastrointestinal (GI) hamartomatous polyposis, alopecia, onychodystrophy, hyperpigmentation, weight loss and diarrhea. The etiology is most likely autoimmune and diagnosis is based on patient history, physical examination, endoscopic findings of GI polyposis and histology. The disease is very rare; thus far more than 500 cases of CCS have been reported globally. A 58-years-old male with CCS was reported in the present case study. The patient experienced a history of diarrhea and hematochezia for 4 months, with abdominal pain for 1 month and additional nail and toenail loss for half a month. The clinical, endoscopic and histological data confirmed the diagnosis.

Cronkhite-Canada syndrome: A rare case report and literature review

Cronkhite-Canada Syndrome (CCS) is a rare, non-hereditary disease characterized by gastrointestinal polyposis associated with diarrhea and epidermal manifestations, such as hyperpigmentation, alopecia, and onychodystrophy. The pathogenesis of CCS is still not well understood but it probably involved autoimmune mechanism. Herein, we here report a case of steroid-responsive CCS in a male patient whose polyps presented with IgG-4 positive plasma cells.

味覚異常を呈したCronkhite-Canada症候群の 4 症例

味覚異常を呈したCronkhite-Canada症候群の 4 症例

Cronkhite‐Canada Syndrome with Complete Remission after Four Months of Prednisolone Therapy and Polypectomy

The etiology of and optimal treatments for Cronkhite‐Canada syndrome (CCS) are still undetermined. Fewer than 5% of CCS patients experience complete remission and 15% of CCS patients develop malignancies. Here, we present a case of CCS involving autoimmune disorders, in which rapid diagnosis, rapid commencement of therapy, and complete remission were achieved after 4 months of prednisolone therapy and polypectomy, although biopsy specimens from all residual colonic polyps revealed adenocarcinoma in one polyp 4 months after prednisolone therapy. It is important to identify gastrointestinal or colonic polyps harboring malignant changes and to examine the involvement of autoimmune mechanisms for better outcomes in CCS patients.

A case of Cronkhite-Canada syndrome

A case of Cronkhite-Canada syndrome

Cronkhite–Canada Syndrome Diagnosis in the Absence of Gastrointestinal Polyps

A 66-year-old male patient presented with nausea, abdominal pain, occasional rectal bleeding, progressive dysgeusia, onicodystrophy, and alopecia. Endoscopic exam and biopsies revealed severe atrophy and diffuse marked edema of mucosa of stomach and duodenum. No evidence of polyps was found in any portion of the gastrointestinal tract. The diagnosis of Cronkhite-Canada syndrome (CCS) was rendered. The patient symptoms resolved completely after initiation of steroid treatment. This additional case of CCS illustrates how the diagnosis of CCS does not require the presence of polyps but is defined by the appreciation of the diffuse marked edema and atrophy of the gastrointestinal mucosa.

A case of Cronkhite-Canada syndrome with gastrointestinal cancer

A 52-year-old woman was admitted to our hospital for further evaluation of intractable bloody diarrhea and a weight loss of 10 kg in two months. She had onychodystrophy, alopecia, hyperpigmentation of the skin, and laboratory examination revealed severe hypoproteinemia (serum total protein 3.8 g/dl) and hypokalemia (1.7 mmol/l). Endoscopy showed diffuse reddish sessile polyposis with edematous inflammatory mucosa in the stomach, small intestine and large intestine. Histological analysis of endoscopically-obtained biopsies demonstrated cystic dilatation of mucosal glands and invasion by inflammatory cells─compatible with Cronkhite-Canada syndrome (CCS)─and one of the pedunculated polyps from the transverse colon was diagnosed as non-invasive adenocarcinoma. Eradication therapy for H. pylori and mesalazine administration was performed as an initial treatment, but no symptomatic improvement was achieved. At that point, prednisolone therapy was initiated at 60 mg/day, tapering in combination with mercaptopurine (6-MP) administration. This treatment gradually improved the patient’s symptoms and nutritional status. The malignant colonic polyp was resected endoscopically. CCS is a rare disorder with nonhereditary gastrointestinal polyposis, and has recently been considered to be a high-risk factor for gastrointestinal carcinoma. Careful examination should be undertaken to ensure gastrointestinal carcinoma is not overlooked in cases of CCS.

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

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.

Successful treatment for Cronkhite-Canada syndrome with endoscopic mucosal resection and salazosulfapyridine

A 79-year-old woman was referred to our hospital because numerous polyps were found in her stomach and large intestine at an ambulatory clinic. Although there were no characteristic symptoms or signs of Cronkhite-Canada syndrome (CCS), endoscopic and pathological findings indicated CCS. Moreover, colonoscopy showed two polypoid lesions (Is type), which appeared neoplastic by magnifying observation with image-enhanced endoscopy (IEE), in the ascending colon. Histologically, the resected specimens revealed tubular adenomas arising in the CCS inflammatory polyps. Remarkable remission of the polyps and edematous mucosa in the stomach and colon was seen after 8 months of administration of salazosulfapyridine (SASP) (3 g/day). Another adenoma was detected and removed endoscopically in the sigmoid colon. This is the first report to describe an asymptomatic case of CCS probably detected in the early phase of the disease, by magnifying IEE which enabled detection and treatment for associated colonic adenomas. SASP was effective in eradication of the inflammatory polyposis, and an additional adenoma was successfully found and removed by surveillance colonoscopy thereafter.

胃癌を合併したCronkhite-Canada症候群の1例

Cronkhite-Canada症候群（CCS）に胃癌を合併した1例を経験したので，若干の文献的考察を加えて報告する．症例は75歳，男性．CCSの診断にて近医通院中，胸やけ症状が出現し，上部消化管内視鏡検査を施行した．胃癌を指摘され，当科紹介受診となった．胃角部前壁に径30mm大の3型腫瘍とその近傍の小弯側に径15mm大の0-IIa+IIc病変が認められた．その他，噴門部から体部にかけて過形成性ポリープが多数認められた．胃癌を合併したCCSの診断で，幽門側胃切除術を施行した．病理所見は，低分化型腺癌および高～低分化型腺癌であった．CCSと胃癌の合併例は自験例を含めると18例の報告があり，分化型腺癌が多く，術式選択は胃全摘か幽門側胃切除に関してcontrovercialである．本症例は幽門側胃切除を施行したが，残存ポリープからの発癌は現在まで認められていない．今後も入念な内視鏡検査が必要と考えられる．

ENDOSCOPICALLY TREATED CRONKHITE-CANADA SYNDROME ASSOCIATED WITH MINUTE INTRAMUCOSAL GASTRIC CANCER: AN ANALYSIS OF MOLECULAR PATHOLOGY

There have been no reports of Cronkhite-Canada syndrome (CCS) associated gastric cancer resected with endoscopy because it is very difficult to identify small cancers that are candidates for endoscopic resection. We report a case of CCS with gastric cancer treated with endoscopic submucosal dissection, and we evaluate the molecular pathological analysis of malignant transformation in patients with CCS. A 74-year-old man had an advanced rectal cancer and gastrointestinal polyposis after presenting with hypoproteinemia, partial hair loss and atrophic nails as well as hyperpigmentation on the hands. He was diagnosed as having CCS. On upper endoscopy, a 7 mm discolored polyp with an irregular microvascular pattern revealed by magnified narrow-band imaging (NBI) was identified in gastric diffuse CCS polyposis. This lesion was treated with endoscopic submucosal dissection and diagnosed as a flat, elevated-type, mucosal well-differentiated tubular adenocarcinoma without lymphatic or venous infiltration, and with tumor-free margins. Microsatellite instability was detected in both the cancer and the surrounding CCS polyps. Mucin-histochemical analysis of the cancer area showed the complete intestinal type, and thus may have differentiated the CCS polyps from that of the common gastric hyperplastic polyps. This case illustrates that a clue to detecting small cancers may be to look for the discolored lesion among reddish CCS polyposis and thereafter to observe the irregular vascular pattern with NBI endoscopy. From the viewpoint of genetic alterations, patients with CCS polyps are considered to be at high risk for developing gastric cancer, and therefore careful follow-up examinations are necessary for the early detection of malignancies.

A case of Cronkhite-Canada syndrome with multiple colon adenomas and early colon cancers

A case of Cronkhite-Canada syndrome with multiple colon adenomas and early colon cancers

A case of Cronkhite-Canada syndrome with hypogeusia

A case of Cronkhite-Canada syndrome with hypogeusia

Cronkhite-Canada syndrome associated withmyelodysplastic syndrome

We report a case of Cronkhite-Canada syndrome (CCS) associated with myelodysplastic syndrome (MDS). A 54-year-old woman, diagnosed as MDS the prior year after evaluation of anemia, visited our hospital with the chief complaint of epigastric discomfort. She also had dysgeusia, alopecia, atrophic nail change, and pigmentation of the palm, all of which began several months ago. Blood tests revealed severe hypoalbuminemia. Colonoscopy (CS) showed numerous, dense, red polyps throughout the colon and rectum. Biopsy specimens showed stromal edema, infiltration of lymphocytes, and cystic dilatation of the crypt. Her clinical manifestations and histology were consistent with CCS. We prescribed corticosteroids, which dramatically improved her physical findings, laboratory data, and endoscopic findings. This is the first report of CCS in a patient with MDS.

A case of Cronkhite-Canada syndrome in which contrast radiologic examinations of the digestive tract were performed at the time of development of the clinical symptoms

A case of Cronkhite-Canada syndrome in which contrast radiologic examinations of the digestive tract were performed at the time of development of the clinical symptoms