Triple carcinomas in Cronkhite-Canada syndrome

The present report describes a 69-year-old man displaying the clinical features of the Cronkhite-Canada syndrome. After taking medicine for the common cold, he suffered hypogeusia and watery diarrhea, eruptions on the lower extremities and an 8 kg loss in body weight. All his finger and toenails began to fall out. He underwent an upper gastrointestinal examination, upon which multiple polyps of the stomach were detected. Three years later, he again developed diarrhea, bloody stools, body weight loss and eruptions on the lower extremities. An upper gastrointestinal series showed a diverticulum of the esophagus and multiple polyps in the stomach. A barium enema examination revealed polyps throughout the entire colon. Endoscopical biopsy specimens revealed juvenile type polyps and adenomas. The patient was treated with predonine therapy and, in a few days, his symptoms improved. Following the predonine therapy, an upper gastrointestinal endoscopy revealed superficial esophageal cancer and early gastric cancer. The patient received successful surgical treatment. Macroscopically, the esophageal cancer was of the superficial type, and its histologic type was that of moderately-differentiated squamous cell carcinoma. The gross finding on the stomach cancer was one of superficial depressed type, and its histologic type was that of well-differentiated tubular adenocarcinoma. One year later, lung cancer was detected. The gross appearance of the resected lung tumor was one of a grayish-white color and the neoplasm was histologically diagnosed as undifferentiated carcinoma, small and large cell type. The coexistence of carcinoma of the gastrointestinal tract with Cronkhite-Canada syndrome has been reported in 21 cases. We have found no report, however, of lung cancer associated with Cronkhite-Canada syndrome. The case described herein is, therefore, the first case of Cronkhite-Canada syndrome to be associated with esophageal, gastric and lung cancer.