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A Case of Ascending Colon Cancer Complicated by Cronkhite-Canada Syndrome Treated with Robot-Assisted Right
Shigeyuki Hamanaka1, Nobuki Ichikawa1, Kengo Shibata1
1Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Introduction:
Cronkhite-Canada syndrome (CCS) is a rare non-hereditary disorder in which multiple non-tumorous polyps occur throughout the digestive tract. Although surgical treatment is sometimes indicated due to the occurrence of gastric and colorectal cancer, in CCS, the polyposis makes it difficult to distinguish from cancer and requires careful follow-up. CCS is characterized by the presence of inflammatory findings, and steroids and immunosuppressants are used as key drugs. So, it is crucial to perform minimally invasive surgeries whenever possible, and in this regard, robotic-assisted surgery might prove to be one of the appropriate approaches.
Case Presentation:
The patient was a 72-year-old woman who had developed CCS 5 years previously and had been in remission with medication. During annual colonoscopy, multiple colorectal polyps were found in the ascending colon and resected endoscopically. One of the polyps was diagnosed as an adenocarcinoma with deep infiltration and vascular invasion. The patient was referred to our department for additional resection and a robotic-assisted right colectomy was performed. Pathological findings showed no residual tumor in the area after endoscopic mucosal resection (EMR), but laterally spreading tumor (LST) lesion showed adenocarcinoma in adenoma. The patient was discharged home on POD 7 without any postoperative complications.
Conclusions:
This report is the first case of robotic surgery for colorectal cancer complicated by CCS with a safe surgical outcome.
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