Totally Laparoscopic Management with Natural Orifice Specimen Retrieval of a Rare Incidental Synchronous Colonic and Endometrial Cancer
Published: 2023-12-11
Page: 625-630
Issue: 2023 - Volume 6 [Issue 2]
Ganesh Shenoy *
Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, No 14, Cunningham Road, Vasanthnagar, Bangalore, Karnataka, 560062, India.
Amol S. Jeur
Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, No 14, Cunningham Road, Vasanthnagar, Bangalore, Karnataka, 560062, India.
Marina Thomas
Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, No 14, Cunningham Road, Vasanthnagar, Bangalore, Karnataka, 560062, India.
Rubina Shanawaz
Department of Minimal Access Gynecology, Fortis Hospital, No 14, Cunningham Road, Vasanthnagar, Bangalore, Karnataka, 560062, India.
Ramesh B. S.
Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, No 14, Cunningham Road, Vasanthnagar, Bangalore, Karnataka, 560062, India.
Nawab Jan
Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, No 14, Cunningham Road, Vasanthnagar, Bangalore, Karnataka, 560062, India.
*Author to whom correspondence should be addressed.
Abstract
Aim: To present a rare case report of non-familial incidentally detected synchronous cancer involving splenic flexure of colon and endometrium managed by totally laparoscopic approach with both the specimens retrieved through vagina.
Presentation of Case: A 56-year-old lady presented with pain abdomen and on evaluation diagnosed to have carcinoma of splenic flexure colon and endometrial cancer.
Discussion: Synchronous transverse colon /splenic flexure and endometrial cancer is a very rare entity. In our case CECT played a vital role in early detection of asymptomatic colonic malignancy. Traditionally, the surgery for simultaneous double cancer of the colon and uterus required a large laparotomy incision to the upper and lower abdomen. After extensive literature search, we believe this is the first reported case of non-familial synchronous malignancy of splenic flexure of colon and endometrium which was managed by totally laparoscopic approach and specimen retrieved through natural orifice.
Conclusion: Totally laparoscopic approach with natural orifice retrieval of specimens for synchronous gastrointestinal and endometrial malignancy is safe and feasible in experienced hands.
Keywords: Synchronous cancer, endometrial cancer, colonic cancer, lynch syndrome, laparoscopic extended left hemicolectomy
How to Cite
Downloads
References
Moertel CG. Multiple primary malignant neoplasms: historical perspectives Cancer. 1977;40(4Suppl):1786-1792.
Lanspa SJ, Lynch HT, Smyrk TC, et al. Colorectal adenomas in the Lynch syndromes: Results of a colonoscopy screening program, Gastroenterology. View at: Google Scholar. 1990;98;5:1117-1122.
Moller P, Seppala TT, Bernstein I, Holinski-Feder E, Sala P, Gareth Evans D, et al. Cancer risk and survival in path_MMR carriers by gene and gender up to 75 years of age: a report from the Prospective Lynch syndrome database. Gut. 2018; 67(7):1306–1316. DOI: 10.1136/gutjnl-2017-314057
Cuquerella J, Ortí E, Canelles P, Quiles F, Pamos SY col. Càncer colorrectal, concepto de neoplasias sincrónicas y metacrónicas. Rev Sdad Val Patol Dig. 2009;19:57-60.
Eisner RF, Nieberg RK, Berek JS. Synchronous primary neoplasms of the female reproductive tract. Gynecol Oncol. 1989;33:335-339.
Woodruff JD, Solomon D, Sullivant H. Multifocal disease in the upper genital canal. Obstet Gynecol. 1985;65:695-698.
Hampel H, Bennett RL, Buchanan A, Pearlman R, Wiesner GL. A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. Genet Med. 2015;17(1):70-87.
DOI: 10.1038/gim.2014.147
Vasen HFA, Watson P, Mecklin JP, Lynch HT. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative Group on HNPCC. Gastroenterology. 1999;116 (6):1453-1456 [PubMed] [Google Scholar]
Kempers MJE, Kuiper RP, Ockeloen CW, et al. Risk of colorectal and endometrial cancers in EPCAM deletion-positive Lynch syndrome: A cohort study. Lancet Oncol. 2011;12(1):49-55.
[PMC free article] [PubMed] [Google Scholar]
Herman JG, Umar A, Polyak K. Incidence and functional consequences of hMLH1 promoter hypermethylation in colorectal carcinomaProc Natl Acad Sci USA. [Crossref] [PubMed] [Web of Science ®], [Google Scholar]. 1998;95(12):6870-6875.
PMID: 9618505
Parsons MT, Buchanan DD, Thompson B, Young JP, Spurdle AB, Correlation of tumour BRAF mutations and MLH1 methylation with germline mismatch repair (MMR) gene mutation status: A literature review assessing utility of tumour features for MMR variant classification J Med Genet. [Crossref] [PubMed] [Web of Science ®], [Google Scholar]. 2012;49 (3):151-157.
PMID: 22368298
Heald B, Plesec T, Liu X. Implementation of universal microsatellite instability and immunohistochemistry screening for diagnosing lynch syndrome in a large academic medical center J Clin Oncol. [Crossref] [PubMed] [Web of Science ®], [Google Scholar]. 2013;31(10)1336-1340.
PMID: 23401454
Villatoro AR, Domingo AG, Jiménez IR, Palacios MNC. Synchronous Tumour Of The Ovary, Endometrium And Sigmoid; A Case Report And Bibliographic Review. J Med Case Rep Case Series. 2022; 3(09).
Available:https://Doi.org/10.38207/JMCRCS/2022/SEP03090163
Căpîlna ME, Rusu SC, Szabo B, Marian C. Three synchronous primary pelvic cancers-a case report. Rev MedChir Soc Med Nat Iasi. 2014;118(1):107-10.
Mendez LE, Atlass J. Triple synchronous primarymalignancies of the colon, endo- metrium and kidney in a patient with Lynch syndrome treated via minimally invasive techniques. Gynecol Oncol Rep. 2016;17: 29-32.
Li XW, Wang CY, Zhang JJ, Ge Z, Lin XH, Hu JH. Short-term efficacy of transvaginal specimen extraction for right colon cancer based on propensity score matching: A retrospective cohort study. Int J Surg. 2019;72:102- 108. DOI: 10.1016/j.ijsu.2019.07.025 [Accessed on 2019 Jul 27]PMID: 31362128