Case report-malignant transformation in Cronkhite-Canada syndrome polyp

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Cronkhite-Canada syndrome (CCS) is a rare gastrointestinal disorder of unknown etiology.
• While generally considered benign, the malignant potential of CCS-associated polyps remains controversial.
• Physical stress may be a contributing factor to CCS development.

Observation:

• A 55-year-old male presented with diarrhea, weight loss, and taste disturbance, diagnosed with CCS.
• Initial treatment with prednisone (20mg/day) resolved symptoms, but polyps recurred upon dose reduction.
• A sigmoid colon polyp was found to be cancerous during a follow-up colonoscopy.

Findings:

• Physical stress may be a trigger for CCS.
• Malignant transformation occurred in a polyp within the context of CCS.
• Steroid therapy effectively managed diffuse inflammatory polyps but did not prevent neoplastic changes in adenomas.

Implications:

• This case underscores the importance of monitoring for malignancy in patients with Cronkhite-Canada syndrome.
• Endoscopic treatment of existing adenomas is crucial to reduce the risk of neoplastic transformation, even after successful steroid treatment for inflammatory polyps.