Abstract
A 64-year-old woman was admitted to the hospital because of her recent diagnosis of advanced cancer of the ascending colon. She had a past surgical history of endometrial cancer at the age of 49, rectal cancer at the age of 57, and transverse colon cancer at the age of 59. Her father had gastric cancer, her brother had renal cancer, her daughter had ovarian cancer, and her son had brain cancer (glioblastoma). A 15-mm depressed lesion was detected by a follow-up colonoscopy that was performed annually after the transverse colon surgery. Pathological examination of biopsy specimens of the lesion revealed adenocarcinoma, and laparoscopic right hemicolectomy was performed (Stage IIIB, pT3N0M0). Testing for mismatch-repair genes revealed a nonsense mutation in the MSH2 gene ; she was diagnosed with Lynch syndrome. This case suggests that colonoscopic surveillance of patients with Lynch syndrome should include examinations sufficiently thorough to detect rapid-growing lesions at an early stage.
